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在ART治疗的HIV感染者中,除了降脂剂之外,他类药物的作用
Vikram Mehraj1, Jun Chen2, Jean-Pierre Routy1,3
1Research Centre McGill University Health Centre, Montreal, QC, Canada.
Frontiers in immunology
|April 24, 2024
概括
抗逆转录病毒疗法 (ART) 改善了艾滋病毒 (PWH) 感染者的生活,但增加了心血管疾病 (CVD) 的风险. 类药物在降低心血管疾病风险和PWH炎症方面表现有前途.
科学领域:
- 免疫学 免疫学 免疫学
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
背景情况:
- 抗逆转录病毒疗法 (ART) 显著改善了人类免疫缺陷病毒 (HIV) 患者的治疗结果.
- 尽管有ART,但残留的HIV复制,微生物转移和免疫功能障碍会导致艾滋病毒感染者的慢性炎症和免疫激活.
- 接受ART的PWH面临心血管疾病 (CVD) 的风险增加,如心肌梗塞和中风,部分原因是慢性炎症和免疫激活.
研究的目的:
- 审查他类药物的降脂和免疫调节作用,在艾滋病毒感染者 (PWH) 的老年人中.
- 探索他类药物如何减少心血管疾病 (CVD) 风险,而不仅仅是它们在PWH中的降脂特性.
- 考虑非他类降低LDL的药物,如bempedoic酸在管理PWH的潜在作用.
主要方法:
- 批判性审查关于他类药物和bempedoic酸的现有研究.
- 分析来自REPRIEVE随机临床试验的数据.
- 检查ART,生活方式和失脂症对PWH中心血管疾病风险的影响.
主要成果:
- 类药物在减少PWH中心血管疾病方面显示出好处,超过其降脂效果.
- 类药物具有免疫调节特性,有助于减少各种疾病的炎症,包括艾滋病毒.
- 脱脂症,以升高的LDL为特征,在ART的PWH中很常见,并有助于心血管疾病风险.
结论:
- 类药物对PWH具有显著的心血管益处,作为免疫调节剂来减少炎症.
- 进一步研究组合疗法,可能包括bempedoic酸,可以提高心血管疾病预防在老化PWH.
- 管理慢性炎症和免疫激活对于减轻ART的PWH中心血管疾病风险至关重要.
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