Effects of Antiretroviral Therapy on Immune Function and Arterial Inflammation in Treatment-Naive Patients With Human Immunodeficiency Virus Infection
Effects of Antiretroviral Therapy on Immune Function and Arterial Inflammation in Treatment-Naive Patients With Human Immunodeficiency Virus Infection
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DOI：
10.1001/jamacardio.2016.0846
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发表时间：
2016-07-01
期刊：
影响因子：
24
通讯作者：
Grinspoon, Steven K.
中科院分区：
文献类型：
--
作者：
Zanni, Markella V.;Toribio, Mabel;Grinspoon, Steven K.
重要性 接受联合抗逆转录病毒治疗 (ART) 的人类免疫缺陷病毒 (HIV) 感染个体发生心肌梗死的风险增加。 ART 对未接受治疗的 HIV 感染者动脉炎症的影响尚不清楚。 目的 确定新开始 ART 对未接受 ART 的 HIV 感染患者的动脉炎症和其他免疫/炎症指标的影响。 设计、环境、参与者 12 名未接受治疗的 HIV 感染者接受了氟脱氧葡萄糖 F 18 ([F-18]-FDG) 正电子发射断层扫描，以评估动脉情况在开始使用埃替拉韦、考比司他、恩曲他滨和富马酸替诺福韦二吡呋酯（联合 ART）治疗之前和之后 6 个月，进行炎症、用于评估亚临床动脉粥样硬化的冠状动脉 CT 血管造影以及全身免疫和代谢表型分析。还对 12 名未感染 HIV 的前瞻性招募个体作为对照进行了系统免疫和代谢因素评估。该研究于 2012 年 7 月 24 日开始，于 2015 年 5 月 7 日完成。 干预措施 HIV 感染组中的联合 ART。 主要结果和测量 主要结果是 HIV 感染组中 [F-18]-FDG-PET 联合 ART 时主动脉目标背景比 (TBR) 的变化。结果 对于 12 名 HIV 感染参与者（平均 (SD) 年龄，35 [11] 岁），联合 ART 抑制病毒载量（平均 [SD] 对数病毒载量，从 4.3 [0.6] 到 1.3 [0] 拷贝/mL；P
IMPORTANCE Individuals with human immunodeficiency virus (HIV) infection receiving combined antiretroviral therapy (ART) have an increased risk of myocardial infarction. Effects of ART on arterial inflammation among treatment-naive individuals with HIV are unknown.OBJECTIVE To determine the effects of newly initiated ART on arterial inflammation and other immune/inflammatory indices in ART-naive patients with HIV infection.DESIGN, SETTING, PARTICIPANTS Twelve treatment-naive HIV-infected individuals underwent fludeoxyglucose F 18 ([F-18]-FDG) positron emission tomographic scanning for assessment of arterial inflammation, coronary computed tomographic angiography for assessment of subclinical atherosclerosis, and systemic immune and metabolic phenotyping before and 6 months after the initiation of therapy with elvitegravir, cobicistat, emtricitabine, and tenofovir disoproxil fumarate (combined ART). Systemic immune and metabolic factors were also assessed in 12 prospectively recruited individuals without HIV serving as controls. The study began July 24, 2012, and was completed May 7, 2015.INTERVENTIONS Combined ART in the HIV-infected cohort.MAIN OUTCOMES AND MEASURES The primary outcome was change in aortic target-background ratio (TBR) on [F-18]-FDG-PET with combined ART in the HIV-infected group. RESULTS For the 12 participants with HIV infection (mean (SD) age, 35 [11] years), combined ART suppressed viral load (mean [SD] log viral load, from 4.3 [0.6] to 1.3 [0] copies/ mL; P