HCV, but not HIV, is a risk factor for cerebral small vessel disease.
HCV, but not HIV, is a risk factor for cerebral small vessel disease.
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HCV，但不是HIV是脑小血管疾病的危险因素。
DOI：
10.1212/nxi.0000000000000027
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发表时间：
2014-10
期刊：
影响因子：
--
通讯作者：
Byrd D
中科院分区：
文献类型：
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作者：
Morgello S;Murray J;Van Der Elst S;Byrd D
随着艾滋病毒人群的老龄化，血管对神经发病机制的贡献变得越来越重要。已经对脑小血管疾病进行了间接分析，但还没有对人脑进行直接研究来阐明小动脉硬化的危险因素。在 126 个大脑（96 个 HIV+，30 个 HIV-）的深部大脑白质中测量了平均小动脉壁厚度（硬化指数，SI）。研究了年龄、性别、种族、高血压、高脂血症、糖尿病、肥胖、肝硬化、丙型肝炎病毒 (HCV) 感染、疱疹感染、HIV 感染、HIV 风险、可卡因使用、CD4 计数、血浆 HIV 载量以及死亡时联合抗逆转录病毒治疗 (cART) 与 SI 的相关性。年龄、高血压、种族、HCV 和肝硬化与 SI 相关；在 HIV 变量中，只有死亡时的 cART 与 SI 相关。为了解决共线性问题，我们对 HCV 与肝硬化、高血压与种族、高血压与年龄进行了部分相关。随着丙型肝炎病毒的控制，肝硬化就失去了意义；随着高血压得到控制，年龄就失去了意义。对于整个样本，HCV、非裔美国人种族和高血压在多变量分析中占 SI 方差的 15%。每一项都与 SI 独立相关，HCV 的影响最大。对于 HIV 样本，在模型中纳入 cART 将 R2 提高至 0.205，只有 HCV、高血压和 cART 保持显着或趋势水平。这种基于组织的脑动脉疾病分析表明，除了非裔美国人种族、高血压和 cART 之外，HCV 也是一种独立的风险。需要进一步研究来了解 HCV 和 cART 的哪些方面导致脑血管神经发病机制。
With the aging of HIV populations, vascular contributions to neuropathogenesis are increasingly important. Indirect analyses of cerebral small vessel disease have been performed, but there have been no direct studies of human brain to elucidate risk factors for arteriolar sclerosis. Mean arteriolar wall thickness (sclerotic index, SI) was measured in the deep cerebral white matter of 126 brains (96 HIV+, 30 HIV−). Correlations with SI were performed for age, sex, race, hypertension, hyperlipidemia, diabetes, obesity, cirrhosis, hepatitis C virus (HCV) infection, herpes infection, HIV infection, HIV risk, cocaine use, CD4 count, plasma HIV load, and combination antiretroviral therapy (cART) at the time of death. Age, hypertension, race, HCV, and cirrhosis were associated with SI; of the HIV variables, only cART at death was associated with SI. To address colinearity, partial correlations were run with HCV and cirrhosis, hypertension and race, and hypertension and age. With HCV controlled, cirrhosis lost significance; with hypertension controlled, age lost significance. For the entire sample, HCV, African American race, and hypertension accounted for 15% of SI variance in multivariate analysis. Each was independently associated with SI, and HCV had the largest effect. For the HIV sample, inclusion of cART in the model increased R2 to 0.205, with only HCV, hypertension, and cART remaining significant or trend level. This tissue-based analysis of cerebral arteriolar disease demonstrates that HCV constitutes an independent risk, in addition to African American race, hypertension, and cART. Further study is needed to understand what aspects of HCV and cART contribute to cerebrovascular neuropathogenesis.