Cardiovascular disease in patients with HIV
Cardiovascular disease in patients with HIV
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DOI：
10.1016/j.tcm.2017.06.005
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发表时间：
2017-11-01
影响因子：
9.3
通讯作者：
Gaita, Fiorenzo
中科院分区：
文献类型：
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作者：
Ballocca, Flavia;D'Ascenzo, Fabrizio;Gaita, Fiorenzo
随着HIV阳性患者预期寿命的逐步延长，由于高效抗逆转录病毒治疗(HAART)，新的合并症，特别是心血管疾病(CVDS)正成为人们关注的重要问题。在这一人群中观察到，冠状动脉疾病的风险增加，通常在较年轻的年龄。病毒感染和全身炎症、抗逆转录病毒治疗和传统危险因素相互作用，其基本病理生理机制复杂且部分尚不清楚。在准确的风险分层后，一级预防应平衡最佳的HAART以抑制病毒，避免副作用对生活方式的干预和传统危险因素(高血压、血脂异常和糖尿病)的治疗。此外，心血管事件后的管理也是具有挑战性的：经皮和手术的血管重建策略都是有价值的选择，考虑到复发事件的较高比率，谨慎是避免药物-药物相互作用的关键。关于艾滋病毒感染患者的大量循证数据仍然缺乏，建议通常遵循普通人群的建议。因此，我们对文献进行了全面的评价，分析了目前关于HIV感染患者心血管疾病的患病率、预防和治疗的知识。(C)2017 Elsevier Inc.保留所有权利。
With the progressive increase in life expectancy of HIV-positive patient, thanks to "highly active antiretroviral therapy" (HAART), new comorbidities, and especially cardiovascular diseases (CVDs) are emerging as an important concern. An increased risk of coronary artery disease, often in a younger age, has been observed in this population. The underlying pathophysiology is complex and partially still unclear, with the interaction of viral infection and systemic inflammation antiretroviral therapy and traditional risk factors.After an accurate risk stratification, primary prevention should balance the optimal HAART to suppress the virus avoiding side-effects the intervention on life-style and the treatment of traditional risk factors (hypertension, dyslipidemia, and diabetes). Also the management after a cardiovascular event is challenging: revascularization strategies both percutaneous and surgical are valuable options, keeping in mind the higher rates of recurrent events, and caution is essential to avoid drug-drug interactions.Large evidence-based data on HIV-infected patients are still lacking, and recommendations often follow those of general population. Therefore we performed a comprehensive evaluation of the literature to analyze the current knowledge on CVD's prevalence, prevention and treatment in HIV-infected patients. (C) 2017 Elsevier Inc. All rights reserved.