Feeney Eoin R, Mallon Patrick W G
HIV Molecular Research Group, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.
Open Cardiovasc Med J. 2011;5:49-63. doi: 10.2174/1874192401105010049. Epub 2011 Feb 24.
Effective highly active antiretroviral therapy (HAART) for human immunodeficiency virus-1 (HIV) infection has led to marked improvement in life-expectancy for those infected with HIV. Despite reductions in the incidence of AIDS with effective treatment, patients continue to experience considerable morbidity and mortality from non-AIDS illness such as premature cardiovascular disease, liver failure and renal failure. These morbidities, particularly premature cardiovascular disease, are thought to be related to a combination of the effects of an ageing HIV-infected population coupled with long-term effects of HIV infection and antiretroviral therapy (ART). One of the principle drivers behind the well documented increase in the risk of cardiovascular disease in HIV-infected patients is dyslipidemia.This review will focus on the clinical presentation of HIV and ART-associated dyslipidemia, what is known of its patho-physiology, including associations with use of specific antiretroviral medications, and suggest screening and management strategies.
针对人类免疫缺陷病毒1型(HIV)感染的高效抗逆转录病毒疗法(HAART)显著提高了HIV感染者的预期寿命。尽管有效治疗降低了艾滋病的发病率,但患者仍因非艾滋病疾病,如过早出现的心血管疾病、肝衰竭和肾衰竭,而承受相当高的发病率和死亡率。这些疾病,尤其是过早出现的心血管疾病,被认为与HIV感染人群老龄化的影响以及HIV感染和抗逆转录病毒疗法(ART)的长期影响共同作用有关。HIV感染者心血管疾病风险显著增加的一个主要驱动因素是血脂异常。本综述将聚焦于HIV及ART相关血脂异常的临床表现、已知的病理生理学,包括与特定抗逆转录病毒药物使用的关联,并提出筛查和管理策略。