艾滋病毒感染者心血管疾病的特征,预防和治疗:美国心脏协会的科学声明
Circulation
|June 4, 2019
概括
艾滋病毒感染者面临更高的心血管疾病 (CVD) 风险,包括心脏病发作和中风,即使病毒得到控制. 本综述涉及艾滋病毒患者的心血管疾病预防和治疗.
科学领域:
- 心脏病学
- 传染性疾病
- 公共卫生
背景情况:
- 艾滋病毒已经从致命的疾病转变为慢性疾病,
- 与未感染者相比,感染艾滋病毒的人患心血管疾病 (CVD) 比如心肌梗塞,心力衰竭和中风的比例显著增加.
- 这些高心血管疾病风险即使在病毒抑制下仍然存在,并且与慢性炎症和免疫失调有关.
研究的目的:
- 综合审查有关艾滋病毒相关心血管疾病的现有证据,重点关注动脉样硬化心血管疾病和心力衰竭.
- 为艾滋病毒感染者提供心血管疾病预防和治疗的务实建议.
- 解决由于长期结果数据有限而需要更好的理解和管理策略.
主要方法:
- 对大型观察性研究的审查.
- 对HIV治疗的随机对照试验的分析 (注意CVD终点的局限性).
- 检查使用CVD替代终点的小型干预研究.
主要成果:
- 在艾滋病毒感染者中增加心肌梗塞,心力衰竭,中风,肺高血压和心脏突然死亡的风险.
- 考虑到人口和临床因素后,这些风险的持续性.
- 部分原因是与艾滋病毒相关的慢性炎症和免疫失调.
结论:
- 艾滋病毒感染与心血管疾病的严重增加有关.
- 有效的抗逆转录病毒治疗可以控制HIV,但不能完全消除心血管疾病的风险.
- 进一步的研究和量身定制的临床策略对于越来越多的艾滋病毒感染者预防和治疗至关重要.
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