Inflammatory markers and coagulation profile among HIV patients with suspected highly active antiretroviral therapy resistance in Kisii Teaching and Referral Hospital, Kenya

Human Immunodeficiency Virus (HIV) infected patients may develop treatment resistance associated with persistent inflammation and coagulation abnormalities despite Highly Active Antiretroviral Therapy (HAART). However, data on these markers among the suspected HAART-resistant patients in Kisii County remain limited hindering evidence-based monitoring of thrombotic complications. This study therefore evaluated inflammatory markers and coagulation profile among HIV-positive adults suspected to have HAART-resistance at Kisii Teaching and Referral Hospital (KTRH), Kenya. Targeted markers for comparison were C-reactive Protein (CRP) levels, Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT) between suspected HAART- resistant and HAART- susceptible HIV- infected patients. To compare CRP levels, PT and APTT between suspected HAART- resistant and HAART- susceptible HIV-infected patients and to assess the association between CRP levels and PT/APTT at KTRH. A comparative cross-sectional study was conducted among HIV-positive adults categorized as suspected HAART-resistant and HAART-susceptible based on viral load and enrolled through systematic random sampling. Venous blood samples were analysed for CRP and PT/APTT. Differences between CRP, PT and APTT among suspected HAART-resistant and HAART-susceptible were determined using Mann-Whitney U test. Association between CRP levels, PT/APTT and suspected HAART-resistance were determined using binary logistic regression. Correlation between CRP and PT/APTT was determined using Pearson’s correlation. The CRP levels were significantly higher among the suspected HAART-resistant patients compared to HAART-susceptible patients, ( p = 0.01). The PT and APTT were higher in the suspected HAART-resistant patients than the HAART-susceptible patients ( p = 0.002) and ( p = 0.011) respectively. In binary logistic regression analysis, CRP was associated with the suspected HAART-resistance (OR = 1.051,95% CI = 1.025–1.078, p = 0.001). The CRP correlated positively with PT ( r = 0.339, p = 0.001) and APTT ( r = 0.305, p = 0.001) among the suspected HAART-resistant and susceptible groups respectively. The suspected HAART-resistant HIV-positive patients have elevated CRP and prolonged PT and APTT, suggesting persistent immune activation and inflammatory-coagulation hence there is need for early detection of inflammatory-coagulation dysregulation among suspected HAART -resistant patients despite continuous medication.