Cardiovascular Disease in HIV and Hepatitis C: Risk Outcomes after Hepatitis C Eradication (CHROME)

HIV 和丙型肝炎引起的心血管疾病：丙型肝炎根除后的风险结果 (CHROME)

• 批准号: 10017614
• 负责人: Henry Masur
• 金额: --
• 依托单位: CLINICAL CENTER
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10017614
• 关键词: Acute; Age; Antiviral Agents; Baltimore; Biological Markers; C-reactive protein; Cardiac; Cardiovascular Diseases; Chronic; Comorbidity; Development; Enrollment; Extrahepatic; Fibrosis; Funding; Gadolinium; General Population; HIV; HIV Seronegativity; HIV Seropositivity; HIV/HCV; Hepatitis C; Hepatitis C Therapy; Highly Active Antiretroviral Therapy; Immunologic Markers; Individual; Infection; Inflammation; Injury; Institutional Review Boards; Intervention; Life Expectancy; Liver; Longevity; Magnetic Resonance Imaging; Maryland; Microvascular Dysfunction; Morbidity - disease rate; Myocardial; Outcome; Patients; Pilot Projects; Population; Prospective Studies; Protocols documentation; Risk; United States National Institutes of Health; Universities; Virus Diseases; bench to bedside; cardiovascular disorder risk; cardiovascular risk factor; chronic infection; extracellular; immune activation; improved; mortality; programs

Among people living with HIV (PLWH), there is a 50% increased risk of acute myocardial infection compared to the general population. Although the advent of highly active antiretroviral therapy (HAART) has had several benefits for PLWH,including increased life expectancy, the longer life span has also made this population apt to develop comorbidities seen in age-matched individuals without HIV, including cardiovascular disease. In addition, HAART itself is a risk factor for cardiovascular disease (CVD), and persistent inflammation and chronic immune activation caused by HIV and ART results in a proinflammatory state that also increases the risk for cardiovascular disease. Hepatitis C (HCV) is another chronic viral infection with significant morbidity and mortality. The development of directly acting antivirals (DAAs) has dramatically improved the cure rate of HCV treatment. However, besides the effects on the liver, chronic infection with HCV leads to numerous extrahepatic manifestations that are associated with morbidity and mortality, including cardiovascular disease. Therefore, patients co-infected with HCV and HIV have a magnified cardiovascular risk than that of the general population. If treatment of HCV can lower the risk of CVD among HIV and HCV co-infected patients, then this would provide an indication for early HCV treatment in this population. As such, we are initiating a pilot, intervention, non-randomized, controlled prospective study to treat HCV in mono-infected and HIV co-infected individuals and compare cardiovascular risk outcomes to HIV mono-infected controls. This pilot study will demonstrate whether functional cure of HCV reduces myocardial injury and risk of cardiovascular disease. The proposal was funded by the Bench-to-Bedside program at NIH and the IHV ID Department and Merck. The MRIs will be done at the NIH. The IRB of Record will be the University of Maryland Baltimore. The protocol has enrolled 22 patients and should complete enrollment in 2020.

在艾滋病毒感染者中，与一般人群相比，急性心肌感染的风险增加了50%。尽管高效抗逆转录病毒疗法（HAART）的出现给PLWH带来了一些好处，包括预期寿命的延长，但更长的寿命也使这一人群容易出现年龄匹配的无艾滋病毒个体所见的合并症，包括心血管疾病。此外，HAART本身是心血管疾病（CVD）的危险因素，HIV和ART引起的持续炎症和慢性免疫激活导致促炎状态