Deep Vein Thrombosis in Adults with HIV: A Systematic Review and Meta-analysis of Prevalence and Risk Factors

Abstract

Deep vein thrombosis (DVT) is a preventable yet serious complication among people living with human immunodeficiency virus (PLWH), attributed to hypercoagulability, low CD4+ counts, and antiretroviral therapy. Despite the high burden of human immunodeficiency virus (HIV), data on DVT in this population remain scarce, particularly in high-prevalence regions. This study systematically reviews the prevalence, risk factors, and outcomes of DVT in adults with HIV. Following PRISMA guidelines, we extracted data from 23 studies (180,495 participants) and conducted subgroup analyses based on country, continent, study design, and quality. Heterogeneity and publication bias were assessed statistically. The global DVT prevalence among PLWH was 14%, with Africa reporting the highest prevalence (47%) and Europe the lowest (3%). Kenya exhibited the highest country-specific prevalence (74%), whereas the Netherlands and Denmark had the lowest (2%). Cross-sectional studies reported the highest prevalence (16%). Identified risk factors included hospitalization, opportunistic infections, malignancies, and comorbidities such as hypertension and diabetes. Funnel plot asymmetry indicated potential publication bias and small-study effects. DVT poses a significant health burden among PLWH, particularly in Africa. Given the high prevalence and associated risk factors, integrating DVT prevention and management into HIV care is critical. Targeted interventions should focus on modifiable risk factors and enhanced diagnostic strategies to improve patient outcomes. Future studies should address knowledge gaps and methodological variations to guide better prevention and treatment approaches.

Keywords

deep vein thrombosis - HIV - prevalence - risk factors - pulmonary embolism

Authors' Contributions

All authors contributed significantly to this manuscript. A.I. led the conceptualization, methodology, data curation, analysis, drafting, and final approval. A.L.O. and A.I. conducted the literature search and data extraction. Z.A. handled data collection, quality assessment, and interpretation. F.I.T-A. critically reviewed the methodology and data interpretation. F.A. contributed to the study design, data verification, and proofreading. A.A.Y. focused on hematological aspects and risk factor evaluation. R.I.J. and F.I.T-A. performed data analysis using STATA. S.A.K. assisted in data synthesis and discussion writing. M.H.A. provided senior advisory input, manuscript review, and final approval. All authors reviewed and approved the final manuscript and are accountable for its content.

Publication History

Received: 20 March 2025

Accepted: 03 April 2025

Article published online:
25 April 2025

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