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Hemorheologic Abnormalities Associated with HIV Infection: Altered Erythrocyte Aggregation and Deformability

¹From the Ocular Inflammatory Disease Center, Jules Stein Eye Institute, and the ³Department of Ophthalmology, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California; the ⁴Department of Physiology and Biophysics, Keck School of Medicine, University of Southern California, Los Angeles, California; and ⁵Community Eye Medical, Pasadena, California. A project of the Southern California HIV/Eye Consortium.

PURPOSE. To investigate possible alterations of erythrocyte aggregation and deformability, which are factors that can influence blood flow, in human immunodeficiency virus (HIV)–infected individuals and to determine whether these factors are related to the severity of immunodeficiency.

METHODS. Laboratory evaluations were performed on 46 HIV-infected individuals and 44 HIV-negative control subjects. Current and nadir (lowest previous) CD4⁺ T-lymphocyte counts were identified for each subject. Erythrocyte aggregation was measured using a fully automatic erythrocyte aggregometer. Factors related to erythrocyte aggregation were also determined: erythrocyte sedimentation rate (ESR), zeta sedimentation ratio (ZSR), and plasma fibrinogen levels. Erythrocyte deformability was observed at various fluid shear stress levels, with a laser diffraction ektacytometer. Correlations were sought between each of these measures and current or nadir CD4⁺ T-lymphocyte counts, and each measure was compared between three subgroups based on current and nadir CD4⁺ T-lymphocyte counts (severely immunosuppressed, immune reconstituted, never severely immunosuppressed).

RESULTS. The following parameters were significantly different between HIV-infected subjects and controls: increased erythrocyte aggregation, at stasis (P < 0.001) and low shear stress (P < 0.001), increased ESR (P < 0.001), increased ZSR (P < 0.028), increased serum fibrinogen (P = 0.015), and decreased erythrocyte deformability (P < 0.001). Only erythrocyte aggregation at stasis correlated significantly with current CD4⁺ T-lymphocyte count (r = – 0.344, P = 0.022). None of the parameters was significantly different between HIV-infected subgroups.

CONCLUSIONS. Increased aggregation and decreased deformability of erythrocytes are associated with HIV-infection regardless of the severity of immunodeficiency. HIV-infected individuals may be at risk for progressive retinal microvascular damage from persistent hemorheologic abnormalities, despite immune reconstitution associated with potent antiretroviral drug therapies.

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				H. Dadgostar, G. N. Holland, X. Huang, A. Tufail, A. Kim, T. C. Fisher, W. G. Cumberland, H. J. Meiselman, A. Benjamin, and D.-U. Bartsch Hemorheologic Abnormalities Associated with HIV Infection: In Vivo Assessment of Retinal Microvascular Blood Flow. Invest. Ophthalmol. Vis. Sci., September 1, 2006; 47(9): 3933 - 3938. [Abstract] [Full Text] [PDF]