了解艾滋病毒感染者的心血管疾病残留风险
Laventa M Obare1, Victoria R Stephens1, Celestine N Wanjalla1,2,3
1Division of Infectious Diseases, Vanderbilt University Medical Center.
艾滋病毒感染者 (PWH) 接受的他类药物治疗降低了一些心血管风险标志物,但并非所有炎症标志物. 需要对艾滋病毒特异性炎症进行进一步的研究,以便在PWH中更好地预防心血管疾病.
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:
- 由于传统因素和持续的全身炎症,艾滋病毒感染者 (PWH) 面临动脉样硬化心血管疾病 (ASCVD) 的风险增加.
- 特定于艾滋病毒的免疫失调有助于尽管治疗,但仍然存在心血管风险.
研究的目的:
- 审查REPRIEVE试验的研究结果,该试验涉及使用他类药物用于PWH中主要心血管不良事件的初级预防.
- 探索导致残留心血管风险的HIV特定免疫机制.
主要方法:
- 分析来自REPRIEVE试验的数据.
- 对有关艾滋病毒相关炎症和心血管风险的当前文献的综述.
主要成果:
- 在PWH中,他类药物治疗降低了脂蛋白相关的脂酶A2,氧化低密度脂蛋白和高灵敏度C反应蛋白 (hs-CRP).
- 关键的炎症标志物 (例如IL-6,IL-1β,sCD14) 和其他免疫因素没有显著变化.
- 艾滋病毒储存器,T细胞功能障碍和训练有素的免疫力都与残留炎症有关.
结论:
- 尽管抗逆转录病毒药物和他类药物治疗,PWH患者仍然存在残留ASCVD风险.
- 目前正在研究针对性抗炎疗法 (例如IL-6/IL-1β抑制剂,CCR5抗剂) 和免疫调节剂.
- 了解HIV驱动的免疫失调对于开发新的心血管风险减轻策略至关重要.
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