Tersenov George Orestovich & Tersenov Alexander Orestovich

Conference 2024 Pre-Recorded

Talk Title

Analysis of platelet indices and lipid parameters in HIV-positive patients with cerebral stroke

Authors and Affiliations

Ilya Lebedev1, Yuliya Boldyreva2, Ekaterina Zakharchuk3, Dmitry Tarasov4, Larisa Shhepankevich5, Olga Senatorova1, Aleksandr Tersenov6, Georgiy Tersenov6

1. Department of Pediatric Diseases and Polyclinic Pediatrics, Tyumen State Medical University, Tyumen, Russian Federation
2. Department of Biological Chemistry, Tyumen State Medical University, Tyumen, Russian Federation
3. Department of Neurology with Neurosurgery Course, Tyumen State Medical University, Tyumen, Russian Federation
4. Regional Hospital No. 3, Tobolsk, Russian Federation
5. Department of Neurology, Novosibirsk State Medical University, Novosibirsk, Russian Federation
6. Institute of Clinical Medicine, Tyumen State Medical University, Tyumen, Russian Federation

Abstract 1

Background

Human deficiency virus targets not only immune cells, but also nerve cells by binding to the CD4 molecule on the cell surface. Several studies show that many antiretroviral drugs may affect lipid profile and blood glucose level, what increases the risk of strokes.
In general, the available information on changes in the state of lipid metabolism in HIV positive patients with stroke is insufficient and does not allow to qualify the degree of risk of cerebrovascular accidents due to atherosclerosis. In this regard, the aim of the study was to determine laboratory parameters of lipid metabolism in patients with cerebral stroke against the background of HIV infection.

Methods

There were examined 77 patients with ischemic and 32 patients with hemorrhagic stroke against the background of comorbid HIV infection, who received treatment in hospitals in the Tyumen Region. The study of lipid metabolism parameters was carried out on the Beckman Coulter AU480 analyzer (USA). Blood sampling was carried out on the day of the patients’ admission. The control group consisted of 116 patients. The significance of differences was determined at a two-tailed significance level of p<0.05

Results

The study found lower levels of total cholesterol and low-density lipoproteins in the patients with ischemic stroke against the background of HIV infection. In the patients with hemorrhagic stroke, only a decrease in the level of total cholesterol was noted.

Conclusions

The state of the plasma lipid spectrum in patients with HIV infection and ischemic stroke, in comparison with those with hemorrhagic stroke, shows a lower probability of atherosclerotic genesis of an acute cerebrovascular disorder.

Abstract 2

Background

In addition to the traditional risk factors of the acute cerebrovascular accidents (CVA) such as arterial hypertension, smoking, diabetes mellitus and hyperlipidemia, HIV-infection increases the probability of cerebral vascular accidents.
An important role in the pathogenesis of an acute local vascular damage of the brain is played by the blood coagulation system. In this regard, it is vital to assess the vascular-platelet component of hemostasis.
Emergence and implementation of the high-tech hematology analyzers in laboratory medicine today has made it possible to expand the range of platelet indices of complete blood count and improved the quality of hemostasis disorders diagnostics. In this regard, the aim of the study was to identify changes in laboratory parameters of a complete blood count which characterize the morphofunctional features of platelets in stroke among HIV-positive patients.

Methods

There were examined 112 HIV-positive patients who received treatment for stroke in hospitals of the Tyumen region. The study of the blood parameters was carried out at the analyzer Sysmex XE2100 (Japan). Blood sampling was carried out on the day of patients admission.
The number of platelets and platelet indices were analyzed: MPV – mean platelet volume, PDW – platelet distribution width, PCT – plateletcrit and P-LCR – platelet large cell ratio. The control group consisted of 118 patients. The significance of the differences was determined at the twotailed significance level of p < 0.05.

Results

There was a significant decrease in the number of platelets (p < 0.05), in average, on 34.3% among patients with hemorrhages and HIV infection. Among patients with ischemic stroke this decrease was less pronounced (p = 0.05). A significant decrease in plateletcrit was established among patients with intracranial hemorrhages, while it did not change significantly among patients with cerebral infarction. During evaluation of other platelet parameters, no significant differences were found between patients in experimental and control groups. The coefficient of the giant platelets prevailed by one and a half times in patients with hemorrhages associated with HIV infection, which turned out to be beyond the statistical significance.

Conclusions

The presence of HIV infection leads to a more pronounced, reliable decrease in the number of platelets and plateletcrit among patients with an acute phase of the development of hemorrhagic stroke than in patients with cerebral infarction. The development of intracranial hemorrhage among HIV-positive patients is characterized by an increase of the platelets with a high volume, the level of which increased by one and a half times, being beyond the statistical significance and having as a leading mechanism the intensification of platelet formation in the bone marrow.