Long-term changes in carotid intima-media thickness among HIV-infected children and young adults.
Long-term changes in carotid intima-media thickness among HIV-infected children and young adults.
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DOI：
10.3851/imp2678
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发表时间：
2014
影响因子：
1.2
通讯作者：
McComsey GA
中科院分区：
文献类型：
--
作者：
Ross Eckard A;O'Riordan MA;Storer N;McComsey GA
HIV+患者患心血管疾病(CVD)的风险增加。这项研究评估了长期变化的颈动脉内膜-中层厚度(IMT)作为HIV感染儿童和年轻人心血管疾病风险的替代标记物。这是一项纵向的观察性研究，比较了2-21岁HIV感染者和144周以上的匹配对照组的颈动脉IMT。34名HIV感染者和29名对照被纳入分析。在感染艾滋病毒的人群中，年龄中值为10岁，74%是黑人，65%是女性。91%是围产期感染，82%接受抗逆转录病毒治疗，CD4中位数为681个/mm3。在基线时，HIV感染者的颈内动脉(ICA)和颈总动脉(CCA)IMT(Mm)增加[ICA-HIV+：0.90，对照组：0.73(P<；0.01)；CCA-HIV+：1.00，对照组：0.90(P=0.02)]。两组ICA和CCA的IMT均有较大的年际变化。然而，到第144周，HIV感染组的ICA或CCA IMT没有净变化。在对照组，从基线到第144周，CCA增加了0.1 mm，ICA增加了0.17 mm。颈内动脉和颈总动脉内中膜厚度在144周时相似。尽管艾滋病毒感染儿童和健康对照组的颈动脉内膜厚度每年都不同，可能是由于动脉生长和/或管腔直径的变化，但在整个144周的研究期间，颈动脉内膜厚度几乎没有净变化。这表明，尽管心血管疾病的长期风险增加，但随着时间的推移，感染艾滋病毒的儿童只发生了很小的净变化。
HIV+ patients are at increased risk of cardiovascular disease (CVD). This study assessed long-term changes in carotid intima-media thickness (IMT) as a surrogate marker for CVD risk in HIV-infected children and young adults. This was a longitudinal, observational study comparing carotid IMT in HIV-infected subjects 2–21 years old to matched controls over 144 weeks. 34 HIV-infected and 29 controls were included in the analysis. Among the HIV-infected group, median age was 10 years, 74% black, and 65% female. 91% were perinatally-infected with 82% on antiretroviral therapy and a median CD4 count of 681 cells/mm3. At baseline, HIV-infected had increased internal carotid artery (ICA) and common carotid artery (CCA) IMT (mm) [ICA- HIV+: 0.90, controls: 0.73 (P<0.01); CCA- HIV+: 1.00, controls: 0.90 (P=0.02)]. Relatively large changes in ICA and CCA IMT were seen from year to year in both groups. However, by week 144, there were no net changes in ICA or CCA IMT within the HIV-infected group. In the controls, CCA increased 0.1 mm and ICA increased 0.17 mm from baseline to week 144. ICA and CCA IMT were similar between groups by 144 weeks. Despite variations from year to year in carotid IMT in HIV-infected children and healthy controls, likely due to arterial growth and/or luminal diameter change, little or no net change occurred in carotid IMT over the entire 144-week study period. This suggests that only small net changes occur over time in HIV-infected children despite an increased long-term risk of CVD.