Abstract
Introduction. Through the process of molecular mimicry, human immunodeficiency virus (HIV) infection can increase the concentration of antiphospholipid antibody (APA) which has possible association with thrombosis. The molecular mimicry in this HIV/AIDS patients is influenced by several factors, such as immunocompromised condition, the use of antitretroviral (ARV) therapy, hepatitis B and C coinfection, use of other drugs, and history of intravenous drug user (IDU). We conducted this study to determine the profile and prevalence of antiphospholipid antibody in patients with HIV/ AIDS in Dr. Cipto Mangunkusumo General Hospital. Further, we explored the relationship between APA in HIV/AIDS patients with the factors mentioned before. Methods. This cross sectional study was done on HIV/AIDS outpatient at AIDS Working Group Clinic at Dr. Cipto Mangunkusumo General Hospital. We assessed the patients by history taking and measured their level of antibody anticardiolipin (ACA) dan Anti β2 glycoprotein I (anti-β2 GP1). Subjects were selected using simple random sampling. Descriptive data regarding the characteristics of the subjects and the proportions of APA were presented in numbers and percentages. The bivariate analysis between APA with the history of injecting drug use, the absolute CD4 lymphocyte count, antiretroviral therapy, and chronic hepatitis coinfection was performed using Chi-Square test and Fisher test. Results. APA examination results showed 27 (29,3%) patients were positive for ACA IgM, 77 (83,7%) patients were positive for ACA IgG, 61 (66,3%) patients were positive for anti β2 GP1 IgM, and 7 (7,6%) pateints were positive for anti β2 GP1 IgG. There is significant association between APA and the history of intravenous drug user (IDU) and ARV therapy. No association was observed between CD4 lymphocyte count and hepatitis coinfection with prevalence of APA in patients with HIV/AIDS patient. Conclusion. Proportion of anticardiolipin antibody IgG is higher than IgM (83,7% vs 29,3%), while the proportion of anti-β2 GP1 IgM is higher than IgG (66,3% vs 7,6%).
References
1. Shoenfeld Y, Blank M, Cervera R, Font J, Raschi E, Meroni PL. Infectious origin of the antiphospholipid syndrome*. Ann Rheum Dis. 2006; 65(1): 2–6. 2. Cervera R, Piette JC, Font J, Khamashta MA, Shoenfeld Y, Camps MT, et al. Antiphospholipid syndrome: clinical and immunologic manifestations and patterns of disease expression in a cohort of 1,000 patients. Arthritis Rheum. 2002;46(4):1019-27. 3. Gharavi AE, Pierangeli SS, Espinola RG, Liu X, Colden-Stanfield M, Harris EN. Antiphospholipid antibodies induced in mice by immunization with a cytomegalovirus-derived peptide cause thrombosis and activation of endothelial cells in vivo. Arthritis Rheum. 2002;46(2):545-52. 4. Asherson RA, Cervera R. Antiphospholipid antibodies and infections. Ann Rheum Dis. 2003;62(5):388–93. 5. Gustafsson JT, Gunnarsson I, Kallberg H, Pettersson S, Zickert A, Vikerfors A, et al. Cigarette smoking, antiphospholipid antibodies and vascular events in Systemic Lupus Erythematosus. Ann Rheum Dis. 2015;74(8):1537-43. 6. D’Cruz DP. Antiphospholipid (Hughes) Syndrome: An Overview. In: Khamashta MA, editor. Hughes Syndrome: Antiphospholipid Syndrome. London: Springer London; 2006. p.9-21. 7. Daroca JC, Gutierrez-Cebollada J, Yazbeck H, Berges A, RubiesPrat J. Anticardiolipin antibodies and acquired immunodeficiency syndrome: prognostic marker or association with HIV infection? Infection. 1992;20(3):140-2. 8. Stimmler MM, Quismorio FP, Jr., McGehee WG, Boylen T, Sharma OP. Anticardiolipin antibodies in acquired immunodeficiency syndrome. Arch Intern Med. 1989;149(8):1833-5. 9. Palomo I, Alarcon M, Sepulveda C, Pereira J, Espinola R, Pierangeli S. Prevalence of antiphospholipid and antiplatelet antibodies in human immunodeficiency virus (HIV)-infected Chilean patients. J Clin Lab Anal. 2003;17(6):209-15. 10. Sedláček D, Ulčová-Gallová Z, Milichovská L, Nováková P, Rokyta Z. Seven Antiphospholipid Antibodies in HIV-Positive Patients: Correlation with Clinical Course and Laboratory Findings. Am J Reprod Immunol. 2003;50(6):439–43. 11. Galrao L, Brites C, Atta ML, Atta A, Lima I, Gonzalez F, et al. Antiphospholipid antibodies in HIV-positive patients. Clin Rheumatol. 2007;26(11):1825-30. 12. Constans J, Guerin V, Couchouron A, Seigneur M, Ryman A, Blann AD, et al. Autoantibodies directed against phospholipids or human beta 2-glycoprotein I in HIV-seropositive patients: relationship with endothelial activation and antimalonic dialdehyde antibodies. Eur J Clin Invest. 1998;28(2):115-22. 13. Guglielmone H, Vitozzi S, Elbarcha O, Fernandez E. Cofactor dependence and isotype distribution of anticardiolipin antibodies in viral infections. Ann Rheum Dis. 2001;60(5):500-4. 14. Abbas AK, Lichtman AH. Cellular and Molecular Immunology. In: Abbas A, Lichtman A, editors. Cellular and Molecular Immunology. 5 ed. Philadelphia: Elsevier Saunders; 2005. p.453-76. 15. Maclean C, Flegg PJ, Kilpatrick DC. Anti-cardiolipin antibodies and HIV infection. Clin Exp Immunol. 1990;81(2):263-6. 16. Rohmi S, Tambunan KL, Sukmana N, Harun S. Antibodi antikardiolipin pada penyalahguna heroin suntikan [Tesis]. Jakarta: Fakultas Kedokteran Universitas Indonesia; 2004. 17. Mulhall BP, Naselli G, Whittingham S. Anticardiolipin antibodies in homosexual men: Prevalence and lack of association with human immunodeficiency virus (HIV) infection. J Clin Immunol. 1989;9(3):208-13.
Recommended Citation
Pandjaitan, Inolyn; Sukmana, Nanang; and Effendy, Shufrie
(2017)
"Antiphospholipid Antibody Profile in HIV/AIDS Patients,"
Jurnal Penyakit Dalam Indonesia: Vol. 4:
Iss.
4, Article 4.
DOI: 10.7454/jpdi.v4i4.148
Available at:
https://scholarhub.ui.ac.id/jpdi/vol4/iss4/4
