Management of Dyslipidaemia in HIV-Infected Patients Receiving Antiretroviral Therapy
Management of Dyslipidaemia in HIV-Infected Patients Receiving Antiretroviral Therapy
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接受抗逆转录病毒治疗的艾滋病毒感染者的血脂异常管理
DOI：
10.1177/135965350400900507
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发表时间：
2004
影响因子：
1.2
通讯作者：
J. Gatell
中科院分区：
文献类型：
--
作者：
E. Martinez;M. Tuset;A. Milinkovic;J. Miro;J. Gatell
与治疗艾滋病毒感染相关的血脂异常，特别是使用蛋白酶抑制剂(PI)，可以将胆固醇和甘油三酯(TG)水平提高到需要干预的阈值。最近来自流行病学研究的证据表明，使用抗逆转录病毒药物与增加心血管疾病的风险和发病率之间存在相关性，包括心肌梗死和冠心病。针对HIV患者的血脂异常治疗的主要目标是降低低密度脂蛋白胆固醇(LDL-C)和显著升高甘油三酯水平。饮食策略和锻炼计划可能会被尝试，尽管这些结果并不一致。药物治疗的两种选择是更换抗逆转录病毒药物和使用降脂药物。每种方法都有各自的优点和局限性，保持病毒抑制的需要必须与治疗异常血脂水平的需要相平衡。大多数药物开关将PI成分替换为另一类抗逆转录病毒药物。降脂药物治疗的选择取决于以血脂异常为主的类型和药物相互作用的潜力。推荐他汀类药物、普伐他汀和阿托伐他汀用于低密度脂蛋白水平升高的患者，吉非罗齐或非诺贝特用于甘油三酯水平升高的患者。开发对血脂谱有更有利影响的新的PI应该是有益的。
Dyslipidaemia associated with the treatment of HIV infection, particularly with the use of protease inhibitors (PIs), can raise cholesterol and triglyceride (TG) levels to the thresholds indicated for intervention. Recent evidence from epidemiological studies has shown that there are correlations between antiretroviral drug use and increased risks for, and incidences of, cardiovascular disease, including myocardial infarction and coronary heart disease. The primary goals of dyslipidaemia therapy for HIV patients are reductions of both low-density lipoprotein cholesterol (LDL-C) and markedly elevated TG levels. Dietary strategies and exercise programs may be tried, although these have shown inconsistent results. The two options for drug therapy are switching anti-retroviral agents and using lipid-lowering drugs. Each approach is associated with advantages and limitations, and the need to maintain viral suppression must be balanced with the need to treat abnormal lipid levels. Most drug switches replace the PI component with drugs from another antiretroviral class. Selection of drug therapy for lipid lowering depends on the type of dyslipidaemia predominating and the potential for drug interactions. The use of the statins pravastatin and atorvastatin is recommended for the treatment of patients with elevated LDL-C levels and gemfibrozil or fenofibrate for patients with elevated TG concentrations. Development of new PIs with more favourable effects on the lipid profile should be of benefit.
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DOI：
10.1086/422144
发表时间：
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期刊：
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影响因子：
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发表时间：
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