接受高效抗逆转录病毒治疗（HAART）的HIV-1感染者的N端前B型利钠肽（NT-proBNP）

N-terminal pro-B-type natriuretic peptide (NT-proBNP) in HIV-1 infected individuals on HAART.

作者信息

Berg T, Zdunek D, Stalke J, Dupke S, Baumgarten A, Carganico A, Hess Georg

机构信息

Medizinisches Labor Dr. Berg, Berlin, Germany.

出版信息

Eur J Med Res. 2007 Apr 26;12(4):152-60.

PMID:17509959

Abstract

BACKGROUND

Studies suggest that highly active anti-retroviral therapy (HAART) prolongs life in HIV infected individuals and that HIV infected individuals increasingly suffer from cardiovascular complications. NT-proBNP has been shown to represent an indicator of cardiac function.

METHODS

495 HIV infected individuals under HAART and 1980 blood donors (BD) were tested for N-terminal pro-B-type natriuretic peptide (NT-proBNP). NT-proBNP was performed by an automated electrochemiluminescence immunoassay (ECLIA) method.

RESULTS

HIV infected individuals had significantly higher NT-proBNP levels than age matched blood donors (18-29 y: median: 33 pg/ml HIV vs. 5 pg/ml BD; p = 0.0247; 30-39 y: median: 25 pg/ml HIV vs. 5 pg/ml BD; p = 0.0351; 40-49 y: median: 35.5 pg/ml HIV vs. 5 pg/ml BD; p < 0.0001; 50-59 y: median: 42 pg/ml HIV vs. 36 pg/ml BD; p = 0.3665; 60-69 y: median: 82.5 pg/ml HIV vs. 46 pg/ml BD; p = 0.0055) the effect was consistently found in all age and both gender groups. HIV infected individuals differed from the blood donor control group with respect to cardiovascular risk factors (hypertension, cardiovascular (CV) medication, diabetes mellitus, smoking status). In HIV infected individuals NT-proBNP levels did not correlate to cardiovascular risk factors including GFR except for C-reactive protein (CRP) levels using multivariate analysis. There was also no evidence for cardiotoxic effects due to HAART or specific antiretroviral drugs. High NT-proBNP levels were found in Hepatitis C virus (HCV) infected individuals who had received alpha-interferon therapy.

CONCLUSIONS

HIV infected individuals had higher NT-proBNP levels than age matched blood donors possibly as a result of a higher prevalence of general cardiovascular risk factors and HIV associated risk factors, the finding is consistent with an increased incidence of cardiovascular events described in HIV infected individuals. Further studies on the relationship to cardiovascular outcome are warranted.

摘要

背景

研究表明，高效抗逆转录病毒疗法（HAART）可延长HIV感染者的寿命，且HIV感染者越来越多地患有心血管并发症。NT-proBNP已被证明是心脏功能的一个指标。

方法

对495例接受HAART治疗的HIV感染者和1980名献血者（BD）进行N端前B型利钠肽（NT-proBNP）检测。NT-proBNP采用自动化电化学发光免疫分析（ECLIA）法检测。

结果

HIV感染者的NT-proBNP水平显著高于年龄匹配的献血者（18 - 29岁：中位数：HIV感染者为33 pg/ml，献血者为5 pg/ml；p = 0.0247；30 - 39岁：中位数：HIV感染者为25 pg/ml，献血者为5 pg/ml；p = 0.0351；40 - 49岁：中位数：HIV感染者为35.5 pg/ml，献血者为5 pg/ml；p < 0.0001；50 - 59岁：中位数：HIV感染者为42 pg/ml，献血者为36 pg/ml；p = 0.3665；60 - 69岁：中位数：HIV感染者为82.5 pg/ml，献血者为46 pg/ml；p = 0.0055），在所有年龄组和两性中均一致发现该效应。HIV感染者在心血管危险因素（高血压、心血管（CV）药物治疗、糖尿病、吸烟状况）方面与献血者对照组不同。在HIV感染者中，使用多变量分析时，除C反应蛋白（CRP）水平外，NT-proBNP水平与包括肾小球滤过率（GFR）在内的心血管危险因素无关。也没有证据表明HAART或特定抗逆转录病毒药物存在心脏毒性作用。在接受α干扰素治疗的丙型肝炎病毒（HCV）感染者中发现了高NT-proBNP水平。