Venous Thromboembolic Disease and Hypercoagulability in Human Immunodeficiency Virus Infection

  • Michael T. Bender
  • Sarah Louise O’BeirneEmail author


Human immunodeficiency virus (HIV) infection is associated with an increased risk of venous thrombosis compared to that of the general population. In addition to traditional risk factors for venous thromboembolism (VTE) such as age, smoking and hospitalization, several of which are more prevalent in HIV-infected individuals, HIV-specific factors including the degree of immunosuppression, presence of opportunistic infections and malignancy, HIV-related coagulation abnormalities and medications used in the treatment of HIV, also contribute to this increased risk. The incidence of arterial thrombosis and cardiovascular disease is also increased in HIV infection, and VTE and arterial thrombosis share many risk factors. Importantly, increased chronic inflammation and immune activation persist in HIV infection even despite effective antiretroviral therapy and play an important role in these disease processes. Given the increased incidence of thrombosis in HIV, it is important that clinicians are alert to the condition in this population. Additionally, a diagnosis of HIV should be considered in individuals presenting with unexplained VTE.


Deep venous thrombosis Pulmonary embolism Arterial thrombosis Thrombophilia Combined antiretroviral therapy CD4 Opportunistic infection Inflammation D-dimer Warfarin Novel oral anticoagulant 



Anticardiolipin antibodies


A disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13


Antiphospholipid antibodies


Activated protein C




Combined antiretroviral therapy




C-reactive protein


Cytochrome P




Drug-drug interaction


Disseminated intravascular coagulation


Deep vein thrombosis


Factor V Leiden


Heparin cofactor II


Hepatitis C virus


Human immunodeficiency virus




International normalized ratio


Intravenous drug use


Kaposi’s sarcoma


Lupus anticoagulant




Mycobacterium avium-intacellulare




Non-nucleoside reverse transcriptase inhibitors


Novel oral anticoagulants


Nucleoside/nucleotide reverse transcriptase inhibitors


Opportunistic infection


Odds ratio


Protein C


Pulmonary embolus




Protease inhibitor


Pneumocystis jirovecii pneumonia


Protein S


Relative risk


Soluble P selectin


Tissue factor


Viral load


Venous thromboembolism


von Willebrand factor


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of Pulmonary and Critical Care Medicine, Department of MedicineNew York-Presbyterian Hospital/Weill Cornell MedicineNew YorkUSA
  2. 2.Department of Genetic MedicineWeill Cornell MedicineNew YorkUSA

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