{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:12:07Z","timestamp":1786979527366,"version":"build-2736575974"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T00:00:00Z","timestamp":1642723200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001321","name":"National Research Foundation","doi-asserted-by":"publisher","award":["TTK20110801000022866"],"award-info":[{"award-number":["TTK20110801000022866"]}],"id":[{"id":"10.13039\/501100001321","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002806","name":"Discovery Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100002806","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Disseminated intravascular Coagulation (DIC) is a thrombotic microangiopathy which may complicate a number of severe disease processes including sepsis. Development of microvascular thromboses results in consumption of coagulation factors and platelets and ultimate bleeding. Patients with HIV infection (PWH) often present with baseline dysregulation of the coagulation system which may increase severity and derangement of DIC presentation. Previously, we have shown that HIV is a significant risk factor for development of DIC.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methodology<\/jats:title>\n<jats:p>We conducted a retrospective record review of all DIC screens submitted to our tertiary coagulation laboratory in Johannesburg, South Africa, over a one year period and compared the laboratory presentation of DIC in PWH with presentation of DIC in patients without HIV infection.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Over the year, 246 patients fulfilled the International Society of Thrombosis and Haemostasis (ISTH) diagnostic criteria for DIC\u2013 108 were confirmed HIV-infected and 77 were confirmed uninfected. PWH and DIC presented at a significantly earlier age (41 vs 46 years respectively, p&lt;0.02). The prothrombin time was significantly more prolonged (30.1s vs 26.s), the d-dimer levels were substantially higher (5.89mg\/L vs 4.52mg\/L) and the fibrinogen (3.92g\/L vs 1.73g\/L) and platelet levels (64.8 vs 114.8x10<jats:sup>9<\/jats:sup>\/l) were significantly lower in PWH. PWH also showed significant synthetic liver dysfunction and higher background inflammation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>PWH who fulfil the diagnostic criteria for DIC show significantly more dysregulation of the haemostatic system. This may reflect baseline abnormalities including endothelial dysfunction in the context of inflammation and liver dysfunction.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0262306","type":"journal-article","created":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T19:18:57Z","timestamp":1642792737000},"page":"e0262306","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Diagnosis of human immunodeficiency virus associated disseminated intravascular coagulation"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6360-3488","authenticated-orcid":true,"given":"Elizabeth S.","family":"Mayne","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Mayne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4315-1496","authenticated-orcid":true,"given":"Susan","family":"Louw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,1,21]]},"reference":[{"issue":"3","key":"pone.0262306.ref001","doi-asserted-by":"crossref","first-page":"e0230105","DOI":"10.1371\/journal.pone.0230105","article-title":"HIV-Prevalence in South Africa by settlement type: A repeat population-based cross-sectional analysis of men and women.","volume":"15","author":"A Gibbs","year":"2020","journal-title":"PLoS One"},{"issue":"2","key":"pone.0262306.ref002","doi-asserted-by":"crossref","first-page":"e0148546","DOI":"10.1371\/journal.pone.0148546","article-title":"The High Cost of HIV-Positive Inpatient Care at an Urban Hospital in Johannesburg, South Africa.","volume":"11","author":"LC Long","year":"2016","journal-title":"PLoS One."},{"issue":"50","key":"pone.0262306.ref003","doi-asserted-by":"crossref","first-page":"e2269","DOI":"10.1097\/MD.0000000000002269","article-title":"HIV-Related Medical Admissions to a South African District Hospital Remain Frequent Despite Effective Antiretroviral Therapy Scale-Up.","volume":"94","author":"G Meintjes","year":"2015","journal-title":"Medicine (Baltimore)"},{"issue":"2","key":"pone.0262306.ref004","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1007\/s00134-020-05945-3","article-title":"Management of HIV-infected patients in the intensive care unit.","volume":"46","author":"F Barbier","year":"2020","journal-title":"Intensive Care Med."},{"issue":"3","key":"pone.0262306.ref005","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1177\/1076029607304411","volume":"14","author":"S Louw","year":"2008","journal-title":"Clin Appl Thromb Hemost"},{"issue":"1","key":"pone.0262306.ref006","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1089\/aid.2016.0104","article-title":"Ideal Cardiovascular Health and Carotid Atherosclerosis in a Mixed Cohort of HIV-Infected and Uninfected Ugandans","volume":"33","author":"MJ Feinstein","year":"2017","journal-title":"AIDS Res Hum Retroviruses"},{"key":"pone.0262306.ref007","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s12959-018-0189-x","volume":"16","author":"S Louw","year":"2018","journal-title":"Thromb J"},{"issue":"11","key":"pone.0262306.ref008","doi-asserted-by":"crossref","first-page":"ofz303","DOI":"10.1093\/ofid\/ofz303","article-title":"Good Fences Make Good Neighbors: Human Immunodeficiency Virus and Vascular Disease.","volume":"6","author":"ES Mayne","year":"2019","journal-title":"Open Forum Infect Dis"},{"issue":"2","key":"pone.0262306.ref009","first-page":"183","article-title":"Persistently elevated levels of von Willebrand factor antigen in HIV infection. 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