Highly active antiretroviral therapy increases fibrinolytic and protein activity in pregnant women

Main Article Content

Evarista Odaburhine Osime
Catherine Obar



Various studies have examined optimal methods for Prevention of Mother to Child Transmission (PMTCT) of human immunodeficiency virus (HIV) and subsequent outcome of response to highly active antiretroviral therapy (HAART) as well as the impact of pregnancy on outcomes of HIV in the Pre-HAART era. Little is known of the impact of pregnancy in response to HAART in Africa. This study is aimed to evaluate euglobulin lysis time (ELT), protein C and protein S in HIV-positive pregnant women on HAART.



This was a cross-sectional study comprised of 150 participants attending Ante-Natal Clinic (ANC) in Central Hospital, Benin City. Pregnant women on HAART (Test subjects) (n=50, mean age 34 years), 50 pregnant newly diagnosed HIV-positive women that had not yet commenced HAART (n=50, mean age 31 years) and 50 pregnant HIV-negative women (n=50, mean age 30 years) which served as controls. The ELT was determined by methods described by Bain, protein C and protein S were determined using Enzyme Linked Immunosorbent Assay (ELISA).



There was a significant increase in ELT in both pregnant women on HAART and not on HAART) when compared to HIV-negative pregnant women (p<0.05). There was a significant decrease in protein C in test subjects when compared with controls (p<0.05) and protein S increased significantly in HIV-positive pregnant women on HAART when compared to those not on HAART and HIV-negative pregnant women (p<0.05).



There are changes in ELT, protein C and protein S parameters with the introduction of HAART in pregnancy.

Article Details

How to Cite
Osime, E. O., & Obar, C. (2018). Highly active antiretroviral therapy increases fibrinolytic and protein activity in pregnant women. Universa Medicina, 37(3), 181–187. https://doi.org/10.18051/UnivMed.2018.v37.181-187
Original Articles
Author Biography

Evarista Odaburhine Osime, Department Of Medical Laboratory Science School Of Basic Medical Sciences College Of Medical Sciences University Of Benin

Department of Medical Laboratory Science

Associate Profesor.


Raman RT, Manimaran P, Rachakatla K, et al. Study of basic coagulation parameters among HIV patients in correlation to CD4 and ART status. J Clin Diagn Res 2016;10:E-4-6. doi: 10.7860/JCDR/2016/17459.7718.

Sturt AS, Dokubo EK, Sint T. Antiretroviral therapy (ART) for treating HIV infection in ART-eligible pregnant women. Cochrane Database Syst Rev 2010;3:CD008440. doi: 10.1002/14651858.CD008440.

World Health Organization. Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. Geneva: World Health Organization; 2015.

Nasir IA, Owolagba A, Ahmad AE, et al. Effects of first-line anti-retroviral therapy on blood coagulation parameters of HIV-infected patients attending a tertiary hospital at Abuja, Nigeria. Malaysian J Pathol 2016;38:103-9.

Pau AK, George JM. Antiretroviral therapy: current drugs. Infect Dis Clin North Am 2014;28:371–402. doi:10.1016/j.idc.2014.06.001.

Simmonds MJ, Meiselman HJ, Baskurt OK. Blood rheology and aging. J Geriatr Cardiol 2013;10: 291-301. doi: 10.3969/j.issn.1671-5411.2013.03.010.

Bositis CM, Gashongore I, Patel DM. Updates to the World Health Organization’s recommendations for the use of antiretroviral drugs for treating pregnant women and preventing HIV infection in infants. Med J Zambia 2010;37:111–7.

Bartlett TA, Michael FT, Demasi RH, et al. An updated systemic overview of triple combination therapy in antiretroviral-naive HIV-infected adults. AIDS;2010:20;2051-64.

Thompson MA, Aberg JA, Hoy JF, et al. Antiretroviral treatment of adult HIV infection: recommendations of the International Antiviral Society-USA Panel. JAMA. 2012;308:387-402. doi:10.1001/jama.2012.7961.

Odunukwe N, Idigbe O, Kanki P, et al. Haematological and biochemical response to treatment of HIV-1 infection with a combination of nevirapine +stavudne+lamivudine in Lagos, Nigeria. Turkish J Hematol 2009;22:125-31.

Omoregie R, Osakue SI, Ihemeje V, et al. Correlation of CD4 count with platelet count, prothrombin time and activated partial thromboplastin time among HIV patients, Benin City, Nigeria. West Indian Med J 2009:58:437-40.

Pintao M, Garcia A, Borgel D, et al. Detection duplication in PROST is relatively common in point mutation negative hereditary protein S deficiency. Hum Genet 2009:126:449-56.

Marks KM, Clarke RMA, Bussel JB, et al. Risk factors for thrombocytopenia in HIV-infected persons in the era of potent antiretroviral therapy. J Acquir Immune Defic Syndr 2009;52:595-9. doi: 10.1097/QAI.0b013e3181b79aff.

Bain BJ, Bates I, Laffan AM. Dacie and Lewis practical haematology. 12th ed. Philadelphia: Elsevier;2017.

Browner WS, Newman TB, Hulley SB. Estimating sample size and power: applications and examples. In: Hulley SB, Cummings SR, Browner WS, Grady DG, Newman TB, editors. Designing clinical research. 4th ed. Philadelphia: Lippincott Williams & Wilkins;2013.

Bibas M, Biava G, Antinori A. HIV-associated venous thromboembolism. Mediterr J Hematol Infect Dis 2011;3:e2011030. doi: 10.4084/MJHID.2011.030.

lbeh BO, Omodamiro DO, lbeh U, et al. Biochemical and haematological changes in HIV subjects receiving winniecure antirethroviral drug in Nigeria. J Biomed Sci 2013;20:73. https://doi.org/10.1186/1423-0127-20-73.

Katz D, Beilin Y. Disorders of coagulation in pregnancy .Br J Anaesth 2015;115 Suppl 2:ii75-88. doi: 10.1093/bja/aev374.

Eyal A, Veller M. HIV and venous thrombotic events. South African J Surg 2009;47:93-5.

Osime EO, Onakewhor JU, Kolade SO. Fibrinolytic changes in pregnant women on highly active antiretroviral therapy. Saudi Med J 2015;36:200-3.

Gahir S, Anger GT, Ibrahim M, et al. Management of HIV positive pregnancies in Ontorio: current status. Canadian J Clin Pharmacol 2009;16::68-77.

Danese S, Vetrano S, Zhang L, et al. The protein C pathway in tissue inflammation and injury: pathogenic role and therapeutic implications. Blood 2010; 115:1121-30. doi: 10.1182/blood-2009-09-201616.