Abstract Number: PB0842
Meeting: ISTH 2021 Congress
Background: Thrombotic thrombocytopenic purpura (TTP) is a potentially fatal thrombotic microangiopathic disorder that might occur secondary to human immunodeficiency virus (HIV) infection. The pathogenesis involves a deficiency of the von Willebrand factor (VWF) cleaving protease ADAMTS13 and the presence of anti-ADAMTS13 autoantibodies.
Aims: Compare ADAMTS13 level and activity in HIV associated TTP patients to an HIV positive non-TTP control group.
Methods: Plasma from fifty-nine (59) patients diagnosed with HIV-associated TTP and hundred (100) HIV positive plasma samples from HIV infected patients without TTP were used as controls. ADAMTS13 levels and activities were performed (Technoclone kits).
Results: The ADAMTS13 antigen levels of HIV-associated TTP patient plasma samples ranged from 0% – 48%, including 8 samples having undetectable ADAMTS13 antigen levels of 0%. The ADAMTS13 activity levels were all under 10%. Hundred (100) control plasma samples from HIV positive patients without TTP had ADAMTS13 antigen levels ranging from 36% – 130% with ~85% in the normal range of 50% – 160% and 15% with slightly low levels of 36% – 50%. The ADAMTS13 activity levels detected in this control group of patients with HIV infection but without TTP ranged from 25% – 116%, with 11% being below 50% (25-49%), and 89% in the normal range (50-150%). The ADAMTS13 antigen and ADAMTS13 activity levels of the HIV-associated TTP group and the HIV positive control group were compared and differs statistically significantly with a p-value of <0.05.
Conclusions: Fifteen, 15 (15%) of the 100 HIV positive cohort plasma samples had slightly reduced ADAMTS13 levels ranging from 36 to 50% (normal range is from 50-150%). It is suggested that the synthesis of metalloproteases, such as ADAMTS13 protein, might be decreased in HIV positive due to micronutrient deficiencies. However, HIV might not be the trigger to HIV-associated TTP. Reduced ADAMTS13 antigen and activity levels have only pathophysiological relevance in HIV-associated TTP.
To cite this abstract in AMA style:Meiring M, MK. HIV is Not the Trigger for HIV-associated TTP [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/hiv-is-not-the-trigger-for-hiv-associated-ttp/. Accessed August 8, 2022.
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