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Updated: Jul 11, 2025

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艾滋病毒感染者的冠状动脉微循环功能障碍及其与抗逆转录病毒治疗的关联
Daniel M Huck1, Brittany Weber1, Sean Parks1
1Cardiovascular Imaging Program, Departments of Medicine and Radiology Brigham and Women's Hospital, Harvard Medical School Boston MA USA.
Journal of the American Heart Association
|November 10, 2023
概括
与对照人群相比,艾滋病毒感染者 (PWH) 的冠状动脉微血管功能减弱. 将抗逆转录病毒疗法从含有阿巴卡维尔的疗法转换为不含阿巴卡维尔的疗法,并没有改善这一功能.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 艾滋病毒感染和某些抗逆转录病毒药物,如阿巴卡维尔,与内皮功能障碍和心血管风险增加有关.
- 通过PET扫描测量的心肌动脉血流储量 (MBFR) 是冠状动脉微血管健康和心血管风险的关键指标.
研究的目的:
- 将艾滋病毒感染者 (PWH) 的MBFR与匹配的HIV阴性对照进行比较.
- 评估是否从含有阿巴卡维尔的疗法 (多卢特格拉维尔/拉米武丁/阿巴卡维尔) 转换为非阿巴卡维尔疗法 (比克特格拉维尔/埃姆特里西塔宾/TAF) 可以改善PWH中的MBFR.
主要方法:
- 一项横截面研究将37个PWH中的MBFR与使用PET成像的75个匹配的HIV阴性对照进行了比较.
- 一组25个PWH从杜洛特格拉维尔/拉米丁/阿巴卡维尔转换为比克特格拉维尔/埃姆特里西塔宾/TAF,在基线和治疗后评估MBFR.
主要成果:
- 与HIV阴性对照组相比,PWH的平均压力心肌血流量和MBFR显著较低 (分别P < 0.001和P = 0.002).
- 在转换为比克特格拉维尔/埃姆特里西塔宾/TAF后,PWH中的总体MBFR保持不变 (P = 0.61).
- 然而,一个由6个PWH组成的小组,最初的MBFR受损 (<2.00),在转换后MBFR显著增加 (从1.58到2.02,P=0.02).
结论:
- 与没有艾滋病毒的人相比,艾滋病毒感染者表现出冠状动脉微血管功能受损.
- 从含有阿巴卡维尔的抗逆转录病毒疗法转换为比克特格拉维尔/埃姆特里西塔宾/TAF,并没有导致冠状动脉微血管功能的整体改善.
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