Inflammatory Markers and Coagulation Profile among HIV Patients Resistant to Highly Active Antiretroviral Therapy in Kisii Teaching and Referral Hospital, Kenya

Background The HIV infected patients may develop treatment resistance associated with persistent inflammation and coagulation abnormalities despite Highly Active Antiretroviral Therapy (HAART). However, data on these markers among HAART-resistant patients in Kisii County remain limited hindering evidence-based monitoring of thrombotic complications. This study therefore evaluated inflammatory markers and coagulation profile among HIV positive adults at Kisii Teaching and Referral Hospital, Kenya. Targeted markers for comparison were C-reactive protein (CRP) levels, Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT) between HAART- resistant and HAART- susceptible HIV infected patients. Objectives To compare CRP levels, PT and APTT between HAART- resistant and HAART- susceptible HIV infected patients and to assess the association between CRP levels and PT/APTT at Kisii Teaching and Referral Hospital, Kenya. Methods Cross-sectional study was conducted among HIV positive adults categorized as HAART-resistant and HAART-susceptible based on viral load and enrolled through systematic random sampling. Venous blood samples were analysed for CRP and PT/APTT. Differences between CRP, PT and APTT among HAART- resistant and HAART- susceptible were determined using Mann-Whitney U test. Association between CRP levels, PT APTT and HAART resistance were determined using binary logistic regression. Correlation between CRP and PT/APTT was determined using Pearson’s correlation. Results The CRP levels were significantly higher among HAART-resistant patients compared to HAART-susceptible patients, (p = 0.01). The PT and APTT were higher in the HAART-resistant patients than the HAART- susceptible patients (p = 0.002) and (p = 0.011) respectively. In binary logistic regression analysis, CRP was associated with HAART- resistance (OR = 1.051,95% CI = 1.025–1.078, p = 0.001). The CRP correlated positively with PT (r = 0.339, p = 0.001) and APTT (r = 0.305, p = 0.001) among the HAART-resistant and susceptible groups respectively. Conclusion HAART-resistant HIV patients have elevated CRP and prolonged PT and APTT, indicating persistent immune activation and inflammatory–coagulation hence there is need for early detection of inflammatory-coagulation dysregulation among HAART resistant patients despite continuous medication.