Dyslipidemias and Elevated Cardiovascular Risk on Lopinavir-Based Antiretroviral Therapy in Cambodia
Dyslipidemias and Elevated Cardiovascular Risk on Lopinavir-Based Antiretroviral Therapy in Cambodia
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DOI：
10.1371/journal.pone.0160306
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发表时间：
2016-08-31
期刊：
影响因子：
3.7
通讯作者：
Segeral, Olivier
中科院分区：
文献类型：
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作者：
Limsreng, Setha;Marcy, Olivier;Segeral, Olivier
背景：洛匹那韦/利托那韦(LPV/r)在柬埔寨广泛应用，疗效显著，但有关长期代谢毒性的资料很少。方法我们在金边卡尔梅特医院进行了一项横断面的回顾性研究，评估柬埔寨患者在接受基于LPV/r的抗逆转录病毒疗法(ART)后1年的代谢紊乱和心血管风险。收集的数据包括心血管危险因素、空腹血脂和血糖，以及生物临床数据的回溯性收集。我们使用泰国电力管理局(RAMA-EGAT)和抗HIV药物不良反应数据收集(D：A：D)风险方程估计了10年内患冠心病的风险。结果：在115名患者中-平均年龄40.9岁，69.2%的男性，平均服用LPV/r 3.8年-40(34.8%)有高胆固醇血症(>；2.40g/L)，69(60.0%)有低密度脂蛋白胆固醇(<；0.40g/L)。根据Framingham、D：A：D和RAMA-EGAT评分，分别有12名(10.5%)、28名(24%)和9名(7.7%)患者有10年的冠心病风险。根据IDSA-AACTG和法国的建议，分别有51名(44.4%)和36名(31.3%)患者没有达到他们的低密度脂蛋白目标。结论在接受LPV/r治疗的柬埔寨HIV感染者中，血脂异常的患病率很高。大约三分之一的患者低密度脂蛋白水平较高，需要特殊干预。
BackgroundLopinavir/ritonavir (LPV/r) is widely used in Cambodia with high efficacy but scarce data exist on long-term metabolic toxicity.MethodsWe carried out a cross-sectional and retrospective study evaluating metabolic disorders and cardiovascular risk in Cambodian patients on LPV/r-based antiretroviral therapy (ART) for >1 year followed in Calmette Hospital, Phnom Penh. Data collected included cardiovascular risk factors, fasting blood lipids and glucose, and retrospective collection of bioclinical data. We estimated the 10-year risks of coronary heart disease with the Framingham, Ramathibodi-Electricity Generating Authority of Thailand (Rama-EGAT), and the Data Collection on Adverse Effects of Anti-HIV Drugs (D:A:D) risk equations. We identified patients with LDL above targets defined by the French expert group on HIV and by the HIV Medicine Association of the Infectious Disease Society of America and the Adult AIDS Clinical Trials Group (IDSA-AACTG).ResultsOf 115 patients enrolled-mean age 40.9 years, 69.2% male, mean time on LPV/r 3.8 years -40 (34.8%) had hypercholesterolemia (> 2.40 g/L), and 69 (60.0%) had low HDL cholesterol (< 0.40 g/L). Twelve (10.5%), 28 (24%) and 9 (7.7%) patients had a 10-year risk of coronary heart disease >= 10% according to the Framingham, D:A:D, and Rama-EGAT score, respectively. Fifty one (44.4%) and 36 (31.3%) patients had not reached their LDL target according to IDSA-AACTG and French recommendations, respectively.ConclusionPrevalence of dyslipidemia was high in this cohort of HIV-infected Cambodian patients on LPV/r. Roughly one third had high LDL levels requiring specific intervention.