Gaona-Flores Verónica, García-Elorriaga Guadalupe, Valerio-Minero Maricela, González-Veyrand Emma, Navarrete-Castro Rogelio, Palacios-Jiménez Norma, Del Rey-Pineda Guillermo, González-Bonilla César, Monasta Lorenzo
Hospital de Infectologìa Centro Médico Nacional La Raza, CMNR. México.
Curr HIV Res. 2008 May;6(3):267-71. doi: 10.2174/157016208784324985.
Atherosclerosis is a multifactor disease. Lately, infectious factors such as C. pneumoniae have been found to be involved. To determine whether the infection by C. pneumoniae is a risk factor for atherosclerosis in patients with AIDS. Case-control study on 43 patients with AIDS under HAART (16 cases and 27 controls). To document atherosclerosis, a carotid and transcranial Doppler ultrasound was performed. Anti-C pneumoniae antibodies were searched using a microimmunofluorescence test for IgM and IgG levels. To study the associations with risk of atherosclerosis, Odds Ratios were calculated for each IgG anti-C. pneumoniae antibody titre. A titre of 1:64 significantly increased the risk of atherosclerosis. These results suggest that hypertriglyceridemia and C. pneumoniae infection coexistence significantly increases the risk of atherosclerosis. The inverse geometric average of the antibodies titre against C. pneumoniae in individuals with atheromatous plaque fell to 64, two titres above the controls. This difference turned out to be statistically significant. Exposure to C. pneumoniae with antibodies (IgG) should be considered in any HIV diagnosed patient as a risk factor for atherosclerosis, having found that the inverse geometric averages of antibodies titre are significantly different comparing cases and controls, especially in patients with dyslipidemia, hypertriglyceridemia or in patients whose treatments could cause these conditions. In patients with concomitant hypertriglyceridemia, the association increases up to three times. It is advisable that AIDS patients take a serological test to determine exposure to C. pneumoniae, and to assess treatment options.
动脉粥样硬化是一种多因素疾病。最近，已发现诸如肺炎衣原体等感染因素与之相关。为确定肺炎衣原体感染是否为艾滋病患者动脉粥样硬化的危险因素。对43例接受高效抗逆转录病毒治疗（HAART）的艾滋病患者进行病例对照研究（16例病例和27例对照）。为记录动脉粥样硬化情况，进行了颈动脉和经颅多普勒超声检查。使用微量免疫荧光试验检测抗肺炎衣原体抗体的IgM和IgG水平。为研究与动脉粥样硬化风险的关联，计算了每种抗肺炎衣原体IgG抗体滴度的比值比。滴度为1:64时显著增加了动脉粥样硬化风险。这些结果表明，高甘油三酯血症与肺炎衣原体感染并存会显著增加动脉粥样硬化风险。有动脉粥样斑块的个体中抗肺炎衣原体抗体滴度的逆几何平均值降至64，比对照组高两个滴度。结果表明这种差异具有统计学意义。鉴于已发现病例与对照的抗体滴度逆几何平均值存在显著差异，尤其是在血脂异常、高甘油三酯血症患者或其治疗可能导致这些情况的患者中，任何确诊为HIV的患者若接触过抗肺炎衣原体抗体（IgG），都应被视为动脉粥样硬化的危险因素。在伴有高甘油三酯血症的患者中，这种关联增加至三倍。建议艾滋病患者进行血清学检测以确定是否接触过肺炎衣原体，并评估治疗方案。
