Increased use of lipid-lowering therapy in patients receiving human immunodeficiency virus protease inhibitors.
Increased use of lipid-lowering therapy in patients receiving human immunodeficiency virus protease inhibitors.
复制标题
在接受人类免疫缺陷病毒蛋白酶抑制剂的患者中增加使用降脂疗法。
DOI：
10.1016/s0002-9149(03)00622-2
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Iloeje,UchennaH
中科院分区：
文献类型：
--
作者：
Stein,JamesH;Wu,Ying;Kawabata,Hugh;Iloeje,UchennaH
尽管人类免疫缺陷病毒（HIV）蛋白酶抑制剂（PI）可改善HIV感染患者的生存率，但许多接受PI治疗的患者会发生高脂血症，这可能会增加未来冠状动脉事件的风险。本研究的目的是估计HIV患者降脂治疗（LLT）的流行率变化，并评估其与HIV PI使用的相关性。这是一项对在加州医疗补助（MEDI-CAL）行政索赔数据库中登记的HIV感染成人的横断面研究。根据国际疾病分类-第9版代码确定HIV相关和血脂异常诊断的频率。降脂和抗逆转录病毒药物的使用由国家药物代码确定。采用多变量统计技术评价1996年1月至2002年6月PI和降脂药物的使用趋势。MEDI-CAL的艾滋病毒感染者人数从1996年的15，764人到2000年的13，349人不等。HIV感染患者中使用LLT的流行率增加了6倍（1.7%至10.6%，p <0.05），2000年，超过了整个医疗人群的使用率（p = 0.09）。服用PI的患者中LLT的增加率大于未服用PI的HIV感染患者和MEDICAL患者（p = 0.002）。在多变量模型中，年龄增加（比值比2.30）和使用PI（比值比2.08）预测使用LLT（p <0.001）。因此，在服用HIV PI的患者中，LLT的使用增加了六倍以上，速度比一般人群快。尚未证明在服用PI的HIV感染患者中使用LLT可提高生存率。
Although human immunodeficiency virus (HIV) protease inhibitors (PIs) improve survival in patients with HIV infection, many patients receiving PIs develop hyperlipidemia, which may increase risk of future coronary events. The purpose of this study was to estimate the changing prevalence of lipid-lowering therapy (LLT) in patients with HIV and to evaluate its association with the use of HIV PIs. This was a cross-sectional study of adults with HIV infection who were registered in the Medicaid of California (MEDI-CAL) administrative claims database. Frequencies of HIV-related and dyslipidemia diagnoses were determined from International Classification of Diseases-9th Edition codes. Use of lipid-lowering and antiretroviral medications was determined by National Drug Codes. Multivariate statistical techniques were used to evaluate trends in use of PIs and lipid-lowering medications from January 1996 to June 2002. The number of HIV-infected patients in MEDI-CAL ranged from 15,764 in 1996 to 13,349 in 2000. The prevalence of LLT use among HIV-infected patients on PIs increased by sixfold (1.7% to 10.6%, p <0.05), and in 2000, exceeded use in the overall MEDI-CAL population (p = 0.09). The increasing rate of LLT in patients taking PIs was greater than in HIV-infected patients not on PIs and in MEDI-CAL (p = 0.002). In multivariate models, increasing age (odds ratio 2.30) and use of PIs (odds ratio 2.08) predicted use of LLT (p <0.001). Thus, in patients taking HIV PIs, use of LLT increased more than sixfold, at a faster rate than in the general population. It has not been proved that use of LLT in HIV-infected patients taking PIs improves survival.