Capili Bernadette, Anastasi Joyce K
Columbia University School of Nursing, New York, NY, USA.
Medsurg Nurs. 2006 Feb;15(1):14-9, 35; quiz 20.
In recent years, CVD risk factors have been recognized among individuals living with HIV/AIDS (Dube et al., 2003) and have been associated with the medication regimen (HAART) used to manage the diseases. A specific class of HIV medication, protease inhibitors, has been implicated in elevating serum levels of triglyceride and cholesterol in treated individuals (Green, 2002; Penzak & Chuck, 2000). However, current treatments for hyperlipidemia in HIV are not always effective and can be dose-limited due to interactions with HAART regimens (Currier, 2002). Dietary guidelines by the NCEP have been recommended as the first-line approach to managing this condition. Well-controlled studies are needed to test the effectiveness of the NCEP diet on HIV-positive individuals. Published studies have focused primarily on dietary counseling and have lacked randomization, control groups, and adequate description of the counseling intervention. Because the mechanism associated with dyslipidemia and HAART is not fully understood, rigorously controlled dietary studies may provide the opportunity to investigate how diet metabolically affects lipid levels during HAART treatment.
近年来，心血管疾病（CVD）风险因素在感染艾滋病毒/艾滋病的个体中已得到确认（杜贝等人，2003年），并且与用于治疗这些疾病的药物治疗方案（高效抗逆转录病毒疗法，HAART）有关。一类特定的艾滋病毒药物，即蛋白酶抑制剂，已被认为与接受治疗个体的血清甘油三酯和胆固醇水平升高有关（格林，2002年；彭扎克和查克，2000年）。然而，目前针对艾滋病毒感染者高脂血症的治疗并不总是有效，并且由于与HAART治疗方案相互作用，可能存在剂量限制（柯里尔，2002年）。美国国家胆固醇教育计划（NCEP）发布的饮食指南已被推荐为管理这种情况的一线方法。需要进行严格对照的研究来测试NCEP饮食对艾滋病毒阳性个体的有效性。已发表的研究主要集中在饮食咨询方面，缺乏随机分组、对照组以及对咨询干预的充分描述。由于与血脂异常和HAART相关的机制尚未完全了解，严格对照的饮食研究可能会提供机会来调查在HAART治疗期间饮食如何在代谢方面影响血脂水平。
