Premature atherosclerosis in HIV-infected individuals - focus on protease inhibitor therapy
Premature atherosclerosis in HIV-infected individuals - focus on protease inhibitor therapy
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DOI：
10.1097/00002030-200102160-00005
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发表时间：
2001-02-16
期刊：
影响因子：
3.8
通讯作者：
Mooser, V
中科院分区：
文献类型：
--
作者：
Depairon, M;Chessex, S;Mooser, V
目的：与使用蛋白水解酶抑制剂相关的血脂紊乱可能导致动脉粥样硬化的早期发展。本研究的目的是确定中年(30-50岁)HIV感染者服用含有蛋白酶抑制剂的方案6个月或更长时间是否与动脉粥样硬化的发病率增加相关。方法：采用高分辨率B型超声成像对68例HIV阴性和168例HIV感染者的股动脉和颈动脉进行成像，其中136例患者接受蛋白酶抑制剂治疗26.8+/-8.9个月(平均+/-SD)。结果：HIV感染者中有1个或多个斑块的比例高于HIV非感染者(55比38%；P=0.02)，吸烟(61比46%；P=0.03)和高脂血症(56比24%；P<；0.001)。斑块的出现与年龄、男性、血浆低密度脂蛋白胆固醇水平和吸烟独立相关。在单变量Logistic回归分析中，也发现与HIV感染有关。在HIV感染者中，蛋白酶抑制剂治疗与斑块的存在无关。结论：在本研究中检查的中年HIV感染者中，有很大比例的人在股动脉或颈动脉有一个或多个动脉粥样硬化斑块。这一人群中外周动脉粥样硬化的存在与使用蛋白酶抑制剂无关，而是与吸烟和高脂血症等典型的心血管危险因素有关，这些因素适合进行干预。(C)2001年，Lippincott Williams&Wilkins。
Objective: Lipid disorders associated with the use of protease inhibitors may contribute to the premature development of atherosclerosis. The purpose of the present study was to determine whether the administration of a protease inhibitor-containing regimen to middle-aged (30-50 years) HIV-infected individuals for 6 months or longer is associated with an increased prevalence of atherosclerosis.Methods: High-resolution B-mode ultrasound imaging was used to Visualize the femoral and carotid arteries of 68 HIV-negative and 168 HIV-infected individuals, including 136 patients who had received protease inhibitors for 26.8 +/- 8.9 months (mean +/- SD). Atherogenic plaques were defined as a thickening of the intima-media greater than or equal to 1200 mm.Results: The proportion of participants with one or more plaques was higher in the HIV-infected group in comparison with the HIV-negative group (55 versus 38%; P = 0.02), and so was the prevalence of cigarette smoking (61 versus 46%; P = 0.03) and hyperlipidaemia (56 versus 24%; P < 0.001). The presence of plaque was independently associated with age, male gender, plasma low-density lipoprotein cholesterol levels and smoking. in univariate logistic regression analysis, an association was also found with HIV infection. Among HIV-infected subjects protease inhibitor therapy was not associated with the presence of plaque.Conclusions: A large proportion of the middle-aged HIV-infected individuals examined during this study had one or more atherosclerotic plaques within the femoral or carotid arteries. The presence of peripheral atherosclerosis within this population is not associated with the use of protease inhibitors, but rather with 'classic' cardiovascular risk factors such as smoking and hyperlipidaemia, which are amenable to interventions. (C) 2001 Lippincott Williams & Wilkins.