HIV Infection and Cardiovascular Disease
HIV Infection and Cardiovascular Disease
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DOI：
10.1155/2013/252463
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发表时间：
2013-12-30
期刊：
影响因子：
--
通讯作者：
Vitoria M
中科院分区：
文献类型：
--
作者：
Fuchs SC;Beltrami-Moreira M;Oyeledun B;Sow PS;Vitoria M
HIV感染被认为是上个世纪的主要全球公共卫生威胁之一，与19世纪席卷伦敦的霍乱流行病相比，其死亡率增加了数倍。与霍乱杆菌造成的污染不同，预防艾滋病毒感染需要基本卫生设施以外的其他干预措施，而抗逆转录病毒药物目前仍然是将该疾病从亚急性转变为慢性疾病的试金石。1990年代，在治疗艾滋病毒感染者方面采用了高效抗逆转录病毒疗法，使艾滋病毒感染者的健康状况得到改善，寿命延长，同时降低了病毒传播率。有一段时间，人们认为，普遍获得HAART和预防方法效率的逐步提高可以拯救后代[1]。然而，这需要做出巨大努力来扩大艾滋病毒检测、维持持续治疗和实施预防方案。然而，高效抗逆转录病毒疗法并非没有副作用。随着使用HAART的患者中与HIV诱导的免疫缺陷相关的死亡率和发病率的显著降低，HIV感染表现为长期疾病[2]。艾滋病毒感染及其治疗与代谢异常有关[3];非传染性疾病[4，5]的患病率增加，艾滋病相关死亡率已转移到非艾滋病相关疾病[6，7]。在高效抗逆转录病毒疗法出现之前，感染者死于心血管疾病的时间比一般人群早了近20年。在引入HAART后，这种差异持续了大约9年[8]。尽管艾滋病毒感染者的年龄越来越大，但大多数人仍然不到50岁，在美国，到2015年只有一半的人口将达到50岁[9]。因此，艾滋病毒感染患者的长期管理必须扩大到心血管危险因素和冠心病的诊断、治疗和预防。即便如此，目前大多数治疗HIV感染的指南仍然只关注抗逆转录病毒治疗，而没有考虑到与艾滋病无关的合并症的治疗和预防[10-12]。然而，将预防心血管疾病的范例用于艾滋病毒感染的情况需要检测艾滋病毒感染患者中心血管危险因素和冠心病的流行情况。本期杂志介绍了巴西艾滋病毒感染者心血管疾病的情况。巴西是一个在过去二十年中为所有感染者提供免费艾滋病毒治疗的国家，使用高效抗逆转录病毒疗法对医疗保健费用产生了巨大影响，
HIV infection has been considered as one of the major global public health threats of the last century, increasing several times the mortality rate in comparison to the cholera epidemic that swept London in the nineteenth century. Unlike the contamination caused by cholera bacillus, prevention of HIV infection requires other interventions than basic sanitation, and the antiretroviral agents currently remain the touchstone to transform the disease from subacute into a chronic condition. The introduction of highly active antiretroviral therapy (HAART) in the treatment of HIV-infected patients, in 1990s, has allowed better health status and greater longevity among people living with HIV, associated with a reduction in the viral transmission rate. For a while, it has been believed that universal access to HAART and the progressive increase in the efficiency of the prevention methods could save future generations [1]. However, it requires an enormous effort to expand HIV testing, maintenance of sustained treatment, and implementation of prevention programs. Nevertheless, HAART is not free of adverse effects. With the significant reduction of the mortality and morbidity associated with HIV induced immunodeficiency in patients using HAART, the HIV infection is behaving as a long-term sickness [2]. HIV infection and its treatment have been associated with abnormal metabolic profile [3]; increased prevalence of noncommunicable diseases [4, 5] and mortality rate of AIDS-related have shifted to non-AIDS-related conditions [6, 7]. In the pre-HAART era, mortality from cardiovascular disease in infected persons occurred almost two decades earlier than in the general population. After the introduction of HAART, this difference went on to about nine years [8]. Even though the HIV-infected population is getting older, most still ar less than 50 years old and, in the United States, only half of the population will be 50 years in 2015 [9]. Therefore, the long-term management of patients with HIV infection has to be expanded to diagnosis, treatment, and prevention of cardiovascular risk factors and coronary heart disease. Even so, most current guidelines for the treatment of HIV infection are still focused only on antiretroviral treatment and do not take into account the treatment and prevention of comorbidities not related to AIDS [10–12]. However, bringing the paradigm of cardiovascular disease prevention for the scenario of HIV infection requires detection of the prevalence of cardiovascular risk factors and coronary heart disease in HIV-infected patients. In this edition of this journal, a portrait of the Brazilian scenario of cardiovascular disease among HIV-infected patients was presented. Brazil is a country that has provided free access to HIV treatment for the entire population of infected people in the last two decades, and the use of HAART had a great impact on the costs of health care and
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DOI：
10.1097/hjr.0b013e328336a150
发表时间：
2010-10-01
影响因子：
--
作者：
Friis-Moller, Nina;Thiebaut, Rodolphe;Law, Matthew G.
通讯作者：
Law, Matthew G.
影响因子：
4.9
作者：
Steffens, Andre Avelino;Moreira, Leila Beltrami;Fuchs, Flavio Danni
通讯作者：
Fuchs, Flavio Danni
影响因子：
3.7
作者：
Grinsztejn B;Luz PM;Pacheco AG;Santos DV;Velasque L;Moreira RI;Guimarães MR;Nunes EP;Lemos AS;Ribeiro SR;Campos DP;Vitoria MA;Veloso VG
通讯作者：
Veloso VG
影响因子：
5.7
作者：
Ho, Jennifer E.;Hsue, Priscilla Y.
通讯作者：
Hsue, Priscilla Y.
影响因子：
2.2
作者：
Alencastro, Paulo R.;Wolff, Fernando H.;Fuchs, Sandra C.
通讯作者：
Fuchs, Sandra C.