Factors associated with accelerated atherosclerosis in HIV-1-infected persons treated with protease inhibitors
Factors associated with accelerated atherosclerosis in HIV-1-infected persons treated with protease inhibitors
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DOI：
10.1089/108729103321655863
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发表时间：
2003-05-01
影响因子：
4.9
通讯作者：
Bartlett, JG
中科院分区：
文献类型：
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作者：
Lai, SH;Lai, H;Bartlett, JG
最近的证据表明，作为一组蛋白酶抑制剂（PI）可能会加速与动脉粥样硬化相关的某些因素。本研究的目的是评价单个PI（茚地那韦、洛匹那韦、奈非那韦、利托那韦和沙奎那韦）对动脉粥样硬化相关因子的影响。服用沙奎那韦和/或利托那韦的患者与服用其他PI的患者进行比较。2000年5月至2001年7月，在马里兰州的巴尔的摩，对98名年龄在25 ~ 45岁的HIV-1感染的黑人成年受试者进行了血脂谱、C反应蛋白（CRP）水平、冠状动脉钙（CAC）评分和血细胞形态学参数的测定。在这98例患者中，有55例（56.1%）正在服用PI。采用t检验和卡方检验检测组间差异。PI组和非PI组的研究参与者在年龄、性别、体重指数、血压、红细胞和白色细胞计数、自HIV诊断以来的时间和抗逆转录病毒治疗的持续时间方面相似。与接受非PI方案的患者相比，接受茚地那韦、奈非那韦或沙奎那韦的患者平均红细胞体积（MCV）和平均红细胞血红蛋白（MCH）水平显著升高。服用任何PI的患者总胆固醇和低密度脂蛋白显著升高。服用奈非那韦、利托那韦或沙奎那韦的患者比非PI方案的患者更可能有更高的CAC评分（>5）。服用沙奎那韦和/或利托那韦的患者与服用其他PI的患者之间的血脂谱、MCV、MCH、CRP和CAC没有差异。总体而言，观察到的变化可能导致预期与PI患者加速动脉粥样硬化相关的临床变化。
Recent evidence suggests that as a group protease inhibitors (PIs) may accelerate certain factors associated with atherosclerosis. The objective of this study was to evaluate the effect of individual PIs (indinavir, lopinavir, nelfinavir, ritonavir, and saquinavir) on certain factors associated with atherosclerosis. Persons who took saquinavir and/or ritonavir were compared with those on other PIs. Between May 2000 and July 2001, the lipid profiles, C-reactive protein (CRP) levels, coronary artery calcium (CAC) scores, and blood cell morphologic parameters were measured in 98 black adult participants aged 25 to 45 years with HIV-1 infection in Baltimore, Maryland. Among these 98, there were 55 (56.1%) taking PIs. Students' t-test and chi(2) test were used to detect the between-group differences. Study participants in both the PI and non-PI groups were similar in age, sex, body mass index, blood pressure, red and white blood cell counts, time since HIV diagnosis, and duration on anti-retroviral therapy. Compared with those who took non-PI regimens, those who took indinavir, nelfinavir, or saquinavir had significantly higher levels of mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH). Those taking any PI had significantly higher total cholesterol and low-density lipoprotein. Those taking nelfinavir, ritonavir, or saquinavir were more likely to have a higher CAC score (>5) than those on non-PI regimens. There were no differences in the lipid profiles, MCV, MCH, CRP, and CAC between those taking saquinavir and/or ritonavir and those taking other PIs. Overall, the changes noted might lead to anticipation of clinical changes linked to accelerated atherosclerosis in patients on PIs.