FOCUS ISSUE ON HIV AND THE CARDIOMETABOLIC SYNDROME

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 感染人类免疫缺陷病毒(HIV)、使用高效抗逆转录病毒药物疗法(HAART)、不良的生活方式/行为选择、遗传背景和其他因素都会导致相当数量的艾滋病毒携带者的代谢和形态发生不利变化。至少在发达国家，由于过去10年取得的治疗进展，艾滋病毒/艾滋病已经从某些死亡转变为一种慢性的、可控制的疾病，有可能长期健康存活。 但正如本期《心脏代谢综合征杂志》中的文章所概述的那样，仍然存在许多挑战。随着生存时间的延长，艾滋病毒感染者会不会死于工业化世界中老年人最常见的死亡原因，特别是心脏代谢综合征的组成部分(心脏病、中风、肺部疾病、糖尿病)，但死亡年龄更早？艾滋病毒感染和伴随的慢性促炎过程是否会增加这些最常见的死亡原因的风险？心脏代谢综合征是否存在HIV特有的危险因素？最近的观察数据表明，在艾滋病毒感染者中，死于心血管疾病、糖尿病、非艾滋病毒相关癌症和药物滥用的人数可能正在增加(4-8人)。此外，美国疾病控制与预防中心的社会经济和人口数据表明，在新感染艾滋病毒的人中，低收入、受教育程度低、年轻的少数族裔男女获得医疗保健的机会很少，这一比例不成比例(2，3)。这难道不是普通人群中罹患糖尿病、肥胖症、心脏病和癌症风险更高的人群吗？同样，艾滋病毒流行病在世界上资源有限的地区最为严重。随着这些地区变得更加发达和工业化，我们预计将出现“流行病的碰撞”；艾滋病毒和心脏代谢综合征，最近的分析支持这一概念(1)。这些问题很复杂，需要多学科团队和方法来解决。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Infection with human immunodeficiency virus (HIV), use of highly active antiretroviral drug therapies (HAART), undesirable lifestyle/behavioral choices, genetic background, and other factors all contribute to adverse metabolic and morphometric changes in appreciable numbers of adults and children living with HIV. At least in the developed world, HIV/AIDS has transitioned from certain death to a chronic, manageable condition with the potential for long-term salubrious survival, due to therapeutic advances made over the past 10yrs. But many challenges remain, as outlined by the articles in this volume of the Journal of the CardioMetabolic Syndrome. With longer-term survival, will HIV-infected people succumb to the causes of death that are most common among aging humans in the industrialized world, especially components of the cardiometabolic syndrome (heart disease, stroke, lung disease, diabetes), but at an earlier age? Does HIV-infection and the accompanying chronic proinflammatory processes, impart increased risk for these most common causes of death? Are there HIV-specific risk factors for the cardiometabolic syndrome? Recent observational data indicate that deaths from cardiovascular disease, diabetes, non-HIV-related cancer, and drug abuse may be increasing among HIV-infected people (4-8). In addition, socioeconomic and demographic data from the CDC suggest that low-income, poorly educated, young minority men and women with poor access to health care constitute a disproportionate percentage of people newly infected with HIV (2, 3). Are these not the same groups in the general population that are at greater risk for developing diabetes, obesity, heart disease, and cancer? Likewise, the HIV epidemic is most serious in resource-limited areas of the world. As these regions become more developed and industrialized, we anticipate a "collision of epidemics"; HIV and the cardiometabolic syndrome, and recent analyses support this notion (1). The issues are complex and will require multidisciplinary teams and approaches to resolve.