Lozano Fernando
Unidad Clínica de Enfermedades Infecciosas, Hospital Universitario de Valme, Sevilla, España.
Enferm Infecc Microbiol Clin. 2009 Sep;27 Suppl 1:3-9. doi: 10.1016/S0213-005X(09)73439-1.
A large body of evidence indicates that HIV-infected patients, both men and women, as well as adults and children, have a higher risk of developing arteriosclerotic cardiovascular disease. This evidence comes from studies whose main primary variables were the clinical manifestations of arteriosclerotic cardiovascular disease (acute myocardial infarction, silent myocardial ischemia, stroke and peripheral arterial disease) and the distinct markers of premature atherosclerosis and endothelial dysfunction determined in different sites (carotid, coronary or peripheral arteries) and with distinct diagnostic procedures (carotid intimamedia thickening, coronary artery calcification, flow-mediated vasodilation, arterial rigidity, ankle/arm index, etc.). This excess risk of arteriosclerotic cardiovascular disease in HIV-positive patients is clearly associated with the HIV infection per se and with classical cardiovascular risk factors, and, to a lesser extent and less uniformly, with the use of first-generation protease inhibitors. Hypertension, whose association with HIV infection is far less clear, is related to both traditional cardiovascular risk factors and to lipodystrophy.
大量证据表明，无论是男性还是女性，成人还是儿童，感染HIV的患者患动脉粥样硬化性心血管疾病的风险更高。这些证据来自一些研究，其主要的主要变量是动脉粥样硬化性心血管疾病的临床表现（急性心肌梗死、无症状心肌缺血、中风和外周动脉疾病），以及在不同部位（颈动脉、冠状动脉或外周动脉）通过不同诊断程序（颈动脉内膜中层增厚、冠状动脉钙化、血流介导的血管舒张、动脉僵硬度、踝臂指数等）确定的早发性动脉粥样硬化和内皮功能障碍的不同标志物。HIV阳性患者患动脉粥样硬化性心血管疾病的这种额外风险显然与HIV感染本身以及经典心血管危险因素有关，在较小程度上且不太一致地与第一代蛋白酶抑制剂的使用有关。高血压与HIV感染的关联远不那么明确，它与传统心血管危险因素和脂肪代谢障碍都有关。
