预防和治疗心血管疾病在艾滋病毒:在一个不断变化的领域的实际见解
Harris Avgousti1, Matthew J Feinstein1
1Northwestern University Feinsberg School of Medicine, Chicago, Illinois, USA.
Topics in antiviral medicine
|January 10, 2024
概括
艾滋病毒感染者 (PWH) 患心血管疾病 (CVD) 的风险增加了50%. REPRIEVE试验显示,他类药物治疗显著降低了这种风险,为PWH患者的心脏健康管理提供了新的希望.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 艾滋病毒感染者 (PWH) 的风险显著更高 (约. 50%) 的心血管疾病 (CVD) 与一般人群相比.
- 与艾滋病毒相关的心血管疾病的发病因子正在随着抗逆转录病毒疗法 (ART) 和艾滋病毒管理的进步而发展.
- 在PWH中,心血管疾病风险升高受持续病毒载量,CD4+T细胞恢复不良以及C型肝炎共感染等因素的影响.
研究的目的:
- 要总结当前对艾滋病毒感染者 (PWH) 心血管疾病 (CVD) 的理解.
- 突出最近关于PWH中心血管疾病风险降低策略的发现.
- 确定在PWH人群中管理心血管疾病的未来研究领域.
主要方法:
- 来自多个队伍的流行病学数据的审查,检查PWH中的心脏病风险.
- 分析REPRIEVE研究 (预防艾滋病毒血管事件的随机试验) 的研究结果.
- 讨论正在进行的关于降低心脏病风险的非降脂疗法的研究.
主要成果:
- 在REPRIEVE研究中,皮塔瓦斯塔丁治疗动脉样硬化心血管疾病的相对风险降低了35%,超过了一般人群中类似他类药物所见的降低.
- 某些抗逆转录病毒药物和与艾滋病毒相关的因素 (例如病毒载量,CD4计数,共感染) 对心血管疾病风险产生不同的影响.
- 非脂质干预措施,包括抗血栓和炎症调节疗法,正在积极研究中.
结论:
- 类药物在降低PWH动脉样硬化心血管疾病风险方面表现出显著的有效性,特别是在低至中等风险组.
- 需要进一步的研究来探索高强度他类药物和二次预防策略在PWH中的有效性.
- 在PWH中全面管理心血管疾病需要对降脂和非降脂治疗方法的持续调查.
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