Eckhardt Benjamin J, Glesby Marshall J
Albert Einstein College of Medicine, Bronx, New York, USA.
Curr Opin HIV AIDS. 2008 May;3(3):226-33. doi: 10.1097/COH.0b013e3282f6451a.
This review addresses the associations between coronary heart disease and antiretroviral medications, with a specific focus on medications that appear to have neutral or positive effects on coronary heart disease risk factors.
Studies have linked combination antiretroviral therapy with an increased risk of coronary heart disease. Often implicated are the effects of these medications on the metabolic risk factors for coronary heart disease, specifically lipids and glucose homeostasis. Many newer antiretrovirals have fewer metabolic side effects, and antiretrovirals in general may be cardioprotective by reducing inflammation. Whether use of specific antiretroviral regimens will translate into improved cardiovascular outcomes remains to be seen.
Some antiretrovirals appear to be at least neutral with regards to coronary heart disease risk, but it is not clear if any are truly cardioprotective. Nonetheless, it is prudent to consider regimens with limited metabolic side effects in patients with pre-established coronary heart disease risk.
本综述探讨冠心病与抗逆转录病毒药物之间的关联，特别关注那些似乎对冠心病危险因素具有中性或积极影响的药物。
研究表明联合抗逆转录病毒疗法会增加冠心病风险。这些药物对冠心病代谢危险因素的影响，特别是脂质和葡萄糖稳态，常常受到牵连。许多新型抗逆转录病毒药物的代谢副作用较少，总体而言，抗逆转录病毒药物可能通过减轻炎症而具有心脏保护作用。特定抗逆转录病毒治疗方案的使用是否会转化为改善心血管结局仍有待观察。
一些抗逆转录病毒药物在冠心病风险方面似乎至少是中性的，但尚不清楚是否有任何药物具有真正的心脏保护作用。尽管如此，对于已有冠心病风险的患者，考虑使用代谢副作用有限的治疗方案是谨慎之举。
