Mehta Nehal, Reilly Muredach
Cardiovascular Division, Department of Medicine, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, USA.
HIV Clin Trials. 2005 Jan-Feb;6(1):5-24. doi: 10.1310/HT0W-NX2N-U2BM-7LUU.
Atherosclerotic cardiovascular disease (CVD), a leading cause of morbidity and mortality in the general population, is also an increasing cause for concern for HIV-infected patients. A number of risk factors for CVD are also associated with HIV disease and HIV therapy, particularly insulin resistance, metabolic dyslipidemia, and inflammation. For example, atherogenic dyslipidemia, a side effect of HIV therapy, is an established risk for CVD in the non-HIV-infected population. As our understanding of atherosclerotic disease evolves, new markers of CVD risk have been identified, including metabolic syndrome definitions and C-reactive protein, a marker of inflammation. Use of these markers, in association with established risk factor guidelines, may serve as important tools in helping HIV physicians implement drug regimens that allow optimum management of metabolic complications associated with HIV and HAART, and thereby reduce CVD risk. The objective of this article is to review the mechanisms of atherosclerotic CVD and to discuss risk factors and markers that can be applied in the evaluation and treatment of CVD in the HIV-positive population.
动脉粥样硬化性心血管疾病（CVD）是普通人群发病和死亡的主要原因，也是感染HIV患者日益关注的问题。CVD的一些危险因素也与HIV疾病和HIV治疗相关，特别是胰岛素抵抗、代谢性血脂异常和炎症。例如，致动脉粥样硬化性血脂异常是HIV治疗的一种副作用，在未感染HIV的人群中是CVD的既定风险因素。随着我们对动脉粥样硬化疾病认识的发展，已确定了CVD风险的新标志物，包括代谢综合征定义和炎症标志物C反应蛋白。将这些标志物与既定的风险因素指南结合使用，可能成为重要工具，帮助HIV医生实施药物治疗方案，以优化管理与HIV和高效抗逆转录病毒治疗（HAART）相关的代谢并发症，并从而降低CVD风险。本文的目的是综述动脉粥样硬化性CVD的机制，并讨论可应用于评估和治疗HIV阳性人群CVD的危险因素和标志物。
