Factors Affecting the Health of Retinal Vessels in Human Immunodeficiency Virus Patients Beginning Anti-Retroviral Therapy.
Factors Affecting the Health of Retinal Vessels in Human Immunodeficiency Virus Patients Beginning Anti-Retroviral Therapy.
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影响开始抗逆转录病毒治疗的人类免疫缺陷病毒患者视网膜血管健康的因素。
DOI：
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发表时间：
2019
影响因子：
1.5
通讯作者：
P. Price
中科院分区：
文献类型：
--
作者：
L. Edwar;B. Karim;I. P. Wijaya;Ibnu A. Ariyanto;Selita Agnes Tanudjaja;R. Estiasari;Ratna Sitompul;P. Price
对抗逆转录病毒治疗（ART）有反应的HIV患者巨细胞病毒（CMV）负担高，系统评估显示心血管变化加速。我们评估了HIV、ART和CMV对视网膜动脉直径（RAC）的影响，RAC是开始ART治疗的HIV患者血管病变的一种非侵入性测量方法。我们分析了印度尼西亚雅加达79名开始抗逆转录病毒治疗的艾滋病毒患者，年龄中位数（范围）为31岁（19-48岁）。采用Image J软件对ART前（V0）和ART后3-12个月（V3-V12）双眼眼底照片进行RAC评估。检测巨细胞病毒DNA和抗体。通过颈动脉内膜中膜厚度（cIMT）评估全身血管病理。多变量模型评估哪些变量最能预测V12时的RAC值。HIV患者的视网膜动脉较窄，巨细胞病毒抗体水平高于健康对照组。接受ART治疗12个月后RAC下降（p < 0.0001）。右侧RAC与CMV IE-1抗体相关，左侧RAC在V3处与cIMT相关。多变量模型将V12的RAC与V12可检测到的HIV RNA联系起来，并宣布使用酒精饮料，而吸烟习惯具有保护作用。对抗逆转录病毒治疗有反应的HIV患者RAC降低表明微血管的进行性改变不同于大血管的改变。与巨细胞病毒IE-1抗体的相关性表明，频繁的巨细胞病毒再激活可能会加速RAC的下降。这可能是抗逆转录病毒治疗前严重艾滋病毒疾病的一个特征，在多变量模型中与高基线艾滋病毒RNA相关证实了这一点。与饮酒和吸烟的联系证明了可改变的危险因素的复杂模式。
HIV patients responding to antiretroviral therapy (ART) have a high burden of cytomegalovirus (CMV) and display accelerated cardiovascular change assessed systemically. We assessed the effects of HIV, ART and CMV on retinal artery calibers (RAC), as a non-invasive measure of vasculopathy in HIV patients beginning ART. We analysed 79 HIV patients beginning ART in Jakarta, Indonesia, with a median (range) age of 31 (19-48) years. RAC was assessed using Image J software from fundus photos of both eyes, before ART (V0) and after 3-12 months (V3-V12). CMV DNA and antibodies were assessed. Systemic vascular pathology was assessed by carotid intima media thickness (cIMT). Multivariable models assessed which variables best predicted RAC values at V12. HIV patients had narrower retinal arteries and higher levels of CMV antibodies than healthy controls. RAC decreased over 12 months of ART (p < .0001). Right RAC correlated with CMV IE-1 antibody, while the left RAC at V3 correlated with cIMT. Multivariable models linked RAC at V12 with detectable HIV RNA at V12 and declared use of alcoholic drinks, while a smoking habit was protective. Decreases in RAC in HIV patients responding to ART suggest progressive microvascular change distinct from changes assessed in large vessels. Correlations with CMV IE-1 antibodies suggest the decline in RAC may be accelerated by frequent reactivations of CMV. This may be a feature of severe HIV disease before ART, confirmed by associations with high baseline HIV RNA in multivariable models. Links with alcohol consumption and smoking testify to a complex pattern of modifiable risk factors.
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影响因子：
6.4
作者：
Hunt, PW;Martin, JN;Deeks, SG
通讯作者：
Deeks, SG
影响因子：
--
作者：
Klein, R;Klein, BEK;Tsai, MY
通讯作者：
Tsai, MY
影响因子：
6.4
作者：
Parrinello, Christina M.;Sinclair, Elizabeth;Kaplan, Robert C.
通讯作者：
Kaplan, Robert C.
影响因子：
4.4
作者：
Wong, Tien Yin;Islam, F. M. Amirul;Shahar, Eyal
通讯作者：
Shahar, Eyal