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[未治疗的HIV阳性患者的血脂谱。HIV感染:心血管危险因素?]

[Lipid profile in untreated HIV positive patients. HIV infection: cardiovascular risk factor?].

作者信息

Baza Caraciolo B, Pérez de Oteyza C, Carrió Montiel D, Carrió Montiel J C, Salguero Aparicio M, Del Romero Guerrero J

机构信息

Centro Sanitario Sandoval, IMSALUD Area 7 de la Comunidad de Madrid, Madrid, Spain.

出版信息

An Med Interna. 2007 Apr;24(4):160-7. doi: 10.4321/s0212-71992007000400002.

Abstract

INTRODUCTION

Some cases of HIV+ patients with unexplained vascular disease have been reported and many studies are being performed to determine whether HIV infected individuals have an increased cardio-vascular risk (CVR). We propose: to describe lipid profile of untreated HIV+ patients and to compare it with the HIV- and to assess whether any of the lipid abnormalities influence in CVR estimation.

MATERIAL AND METHODS

407 homosexual males: 251 untreated HIV+ and 156 HIV-. Biochemistry parameters: Total cholesterol (CHOL), HDL-cholesterol (HDL), VLDL-cholesterol, LDL-cholesterol (LDL), triglycerides (TG), apolipoproteins A1 and B (ApoA1 y ApoB) and lipoprotein A. Atherogenic rates: CHOL/HDL, LDL/HDL and log (TG/HDL). HIV+ patients were classified into three groups according to CD4 lymphocytes number.

RESULTS

HIV+ patients had lower CHOL, HDL, and ApoA1 and higher CVR rates. These differences showed also between each HIV+ group according to CD4 number and control group HIV-. 76% of the HIV+ patients showed low levels of HDL (less than 40 mg/dL) as compared with 31% of HIV- subjects.

CONCLUSION

Untreated HIV+ patients' lipid profile is different from the HIV- subjects; one. There are decreases in HDL and ApoA1 from the beginning of the infection that persis along all the CD4 levels. HDL decrease in HIV infection multiplies global CVR in HIV infected individuals, independently of other risk factors.

摘要

引言

已报道了一些感染HIV的患者出现不明原因血管疾病的病例,并且正在进行许多研究以确定HIV感染者是否具有更高的心血管风险(CVR)。我们提议:描述未接受治疗的HIV阳性患者的血脂谱,并将其与HIV阴性患者进行比较,以及评估任何血脂异常是否会影响CVR评估。

材料与方法

407名同性恋男性:251名未接受治疗的HIV阳性患者和156名HIV阴性患者。生化参数:总胆固醇(CHOL)、高密度脂蛋白胆固醇(HDL)、极低密度脂蛋白胆固醇、低密度脂蛋白胆固醇(LDL)、甘油三酯(TG)、载脂蛋白A1和B(ApoA1和ApoB)以及脂蛋白A。致动脉粥样硬化率:CHOL/HDL、LDL/HDL和log(TG/HDL)。根据CD4淋巴细胞数量将HIV阳性患者分为三组。

结果

HIV阳性患者的CHOL、HDL和ApoA1较低,CVR率较高。根据CD4数量划分的每个HIV阳性组与HIV阴性对照组之间也存在这些差异。与31%的HIV阴性受试者相比,76%的HIV阳性患者HDL水平较低(低于40mg/dL)。

结论

未接受治疗的HIV阳性患者的血脂谱与HIV阴性患者不同;其一,从感染开始,HDL和ApoA1就降低,并且在所有CD4水平上持续存在。HIV感染中HDL的降低使HIV感染者的整体CVR增加,独立于其他风险因素。

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