Epidemiology of ischemic heart disease in HIV.
Epidemiology of ischemic heart disease in HIV.
复制标题
HIV中缺血性心脏病的流行病学。
DOI：
10.1097/coh.0000000000000410
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发表时间：
2017-11
影响因子：
4.1
通讯作者：
Grinspoon SK
中科院分区：
文献类型：
--
作者：
Triant VA;Grinspoon SK
本综述的目的是总结和综合最近的数据对缺血性心脏病（IHD）的风险在艾滋病毒感染者。该领域的最新研究表明，相对于艾滋病相关诊断，心血管疾病（CVD）对艾滋病毒发病率和死亡率的影响越来越大。研究继续支持HIV引起的IHD风险增加约1.5至2倍，具体风险因性别和病毒学/免疫学状态而异。风险因素包括传统的CVD风险因素和新的HIV特异性因素，包括炎症和免疫激活。特定的抗逆转录病毒治疗（ART）药物可能会增加CVD风险，但ART与病毒抑制的净效应对CVD风险是有益的。心血管风险的管理和心血管疾病的预防是复杂的，因为目前的一般人群策略仅针对传统的心血管疾病风险因素。广泛的研究正在针对开发量身定制的CVD风险预测算法和干预措施，以减少CVD对HIV的风险。IHD风险增加是HIV临床和公共卫生的重大挑战。开发和应用针对艾滋病毒的干预措施来管理心血管疾病的危险因素，降低心血管疾病的风险，将改善这一老龄化人口的长期健康状况。
The purpose of this review is to summarize and synthesize recent data on the risk of ischemic heart disease (IHD) in HIV-infected individuals. Recent studies in the field demonstrate an increasing impact of cardiovascular disease (CVD) on morbidity and mortality in HIV relative to AIDS-related diagnoses. Studies continue to support an approximately 1.5 to 2-fold increased risk of IHD conferred by HIV, with specific risk varying by gender and virologic/immunologic status. Risk factors include both traditional CVD risk factors and novel, HIV-specific factors including inflammation and immune activation. Specific antiretroviral therapy (ART) drugs may increase CVD risk, yet the net effect of ART with viral suppression is beneficial with regards to CVD risk. Management of cardiovascular risk and prevention of CVD is complex, because current general population strategies target traditional CVD risk factors only. Extensive investigation is being directed at developing tailored CVD risk prediction algorithms and interventions to reduce CVD risk to HIV. Increased IHD risk is a significant clinical and public health challenge in HIV. The development and application of HIV-specific interventions to manage CVD risk factors and reduce CVD risk will improve the long-term health of this aging population.