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与非核糖逆转录酶抑制剂相比,使用整合酶链转移抑制剂不会加速亚临床动脉样硬化的进展

Javier García-Abellán^1,2, José A García^1,2, Sergio Padilla^1,2

¹Infectious Diseases Unit, Hospital General Universitario de Elche and Universidad Miguel Hernández de Elche, Alicante, Spain.

The Journal of antimicrobial chemotherapy

|October 25, 2024

概括

与非核糖逆转录酶抑制剂 (NNRTI) 相比,整合酶链转移抑制剂 (INSTI) 在艾滋病毒感染者中不会增加亚临床动脉样硬化进展. 心血管风险与传统因素有关,而不是INSTI使用.

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:

与艾滋病毒感染者的整合酶链转移抑制剂 (INSTI) 相关的心血管风险仍然是争论的主题.
了解这种风险对于优化HIV治疗方案至关重要.

研究的目的:

评估INSTI使用与亚临床动脉样硬化的进展之间的关联.
Carotid intima-media 厚度 (cIMT) 被用作动脉样硬化进展的主要指标.

主要方法:

一项前性研究跟踪了基于INSTI或NNRTI的治疗方案的HIV病毒抑制患者.
Carotid intima-media厚度 (cIMT) 在基线,48周和96周被测量.
统计分析包括考克斯回归,线性混合模型和倾向得分匹配来评估cIMT变化.

主要成果:

在INSTI和NNRTI组之间没有观察到亚临床动脉样硬化进展 (cIMT增加≥10%或新斑块) 的显著差异.
对cIMT进展的连续和分类分析显示,治疗组之间的结果相似.
倾向性得分匹配证实INSTI和NNRTI组之间的2年cIMT变化没有显著差异.

结论:

基于INSTI的治疗方案与基于NRTI的治疗方案相比,与亚临床动脉样硬化进展的增加无关.
传统的心血管风险因素,而不是INSTI使用,与cIMT进展有关.

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