Worsening endothelial function with efavirenz compared to protease inhibitors: a 12-month prospective study.
Worsening endothelial function with efavirenz compared to protease inhibitors: a 12-month prospective study.
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DOI：
10.1371/journal.pone.0045716
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Dubé MP
中科院分区：
文献类型：
--
作者：
Gupta SK;Shen C;Moe SM;Kamendulis LM;Goldman M;Dubé MP
在开始抗逆转录病毒治疗（ART）6个月后，当药物相关效应可能抵消病毒学控制的初始改善时，尚未系统评估肱动脉血流介导的扩张（FMD）的内皮功能变化。我们评估了23名开始ART治疗的受试者6个月和12个月时FMD [以中位数（四分位数1，四分位数3）表示]和循环HIV和心血管生物标志物的变化。尽管CD 4细胞计数和HDL-C显著增加，HIV RNA水平、MCP-1、IP-10、sVCAM-1、sTNFR 2和sCD 14降低，但6个月或12个月时FMD总体上没有显著变化。然而，在12个月时，接受依法韦仑治疗的患者[N =12;-3.50%（-4.90%，0.68%）]与接受蛋白酶抑制剂治疗的患者[N= 11; 1.50%（-0.86%，4.56%）]的FMD变化存在显著差异（P=0.04）。 接受和未接受恩曲他滨/替诺福韦/依法韦仑的患者之间FMD变化的差异更明显，并且在6个月和12个月时均具有显著差异（均为P<0.02）。其他研究显示，在依法韦仑和PI使用之间或在接受和未接受恩曲他滨/替诺福韦/依法韦仑的患者之间，25-（OH）-维生素D、PTH、FGF-23和F2-异前列腺素水平的变化无显著差异。与基于PI的方案相比，使用依法韦仑与12个月时FMD减少相关，而与未接受该组合的患者相比，恩曲他滨/替诺福韦/依法韦仑与6和12个月时FMD减少相关。抗逆转录病毒药物对内皮功能的长期影响可能在HIV感染患者的心血管疾病风险中起重要作用。
Changes in endothelial function, measured as flow-mediated dilation (FMD) of the brachial artery, has not been systematically assessed beyond 6 months of initiation of antiretroviral therapy (ART) when drug-related effects might offset initial improvements with virologic control. We assessed 6 and 12 month changes in FMD [presented as median (quartile 1, quartile 3)] and circulating HIV and cardiovascular biomarkers in 23 subjects initiating ART. There were no significant changes in FMD at 6 or 12 months overall despite significant increases in CD4 cell count and HDL-C and reductions in HIV RNA level, MCP-1, IP-10, sVCAM-1, sTNFR2, and sCD14. However, there were significant differences (P = 0.04) in the changes in FMD between those receiving efavirenz [N = 12; −3.50% (−4.90%, 0.68%)] vs. protease inhibitors at 12 months [N = 11; 1.50% (−0.86%, 4.56%)]. The differences in changes in FMD between those receiving and not receiving emtricitabine/tenofovir/efavirenz were more pronounced and were significantly different at both 6 and 12 months (P<0.02 for both). Additional studies showed no significant differences in changes in 25-(OH)-vitamin D, PTH, FGF-23, of F2-isoprostane levels between efavirenz and PI use or between those receiving and not receiving emtricitabine/tenofovir/efavirenz. Efavirenz use was associated with reduced FMD at 12 months compared to PI-based regimens while emtricitabine/tenofovir/efavirenz was associated with reduced FMD at both 6 and 12 months compared to those not receiving this combination. Long-term effects of antiretrovirals on endothelial function may play an important role in the risk of cardiovascular disease in HIV-infected patients.
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DOI：
10.1086/600890
发表时间：
2009-08-15
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Gupta SK;Komarow L;Gulick RM;Pollard RB;Robbins GK;Franceschini N;Szczech LA;Koletar SL;Kalayjian RC
通讯作者：
Kalayjian RC
DOI：
10.1161/atvbaha.110.211789
发表时间：
2011-02-01
影响因子：
8.7
作者：
Dekker, Douwe;Dorresteijn, Mirrin J.;Smits, Paul
通讯作者：
Smits, Paul
影响因子：
37.8
作者：
Stein, JH;Klein, MA;Sosman, JM
通讯作者：
Sosman, JM
影响因子：
6.4
作者：
Grubb, JR;Dejam, A;Gladwin, MT
通讯作者：
Gladwin, MT
影响因子：
5.4
作者：
Ekmekci, A.;Abaci, N.;Erbil, Y.
通讯作者：
Erbil, Y.