Fourie C, van Rooyen J, Pieters M, Conradie K, Hoekstra T, Schutte A
HART (Hypertension in Africa Research Team), Physiology, North-West University, Potchefstroom, South Africa.
Cardiovasc J Afr. 2011 May-Jun;22(3):134-40. doi: 10.5830/cvja-2010-056.
The chronic infection status suffered by HIV-infected individuals promotes chronic arterial inflammation and injury, which leads to dysfunction of the endothelium, atherosclerosis and thrombosis. Although HIV-1 subtype C is prevalent in South Africa and accounts for almost a third of the infections worldwide, this subtype differs genetically from HIV-1 subtype B on which the majority of studies have been done. The objective of this study was to assess whether newly identified, never-treated, HIV-1-infected South African participants showed signs of endothelial dysfunction, accelerated atherosclerosis and increased blood coagulation. We compared 300 newly diagnosed (never antiretroviraltreated) HIV-infected participants to 300 age-, gender-, body mass index- and locality-matched uninfected controls. Levels of high-density lipoprotein cholesterol (HDL-C), triglycerides, interleukin-6 (IL-6), C-reactive protein (CRP), intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), fibrinogen and plasminogen activator inhibitor-1 (PAI-1), and carotid radialis pulse wave velocity (cr-PWV) were determined. The HIV-infected participants showed lower HDL-C and higher IL-6, CRP, ICAM-1 and VCAM-1 levels compared to the uninfected controls. No differences in fibrinogen and PAI-1 levels were detected. A continuous positive trend of increasing age with cr-PWV was detected in the HIV-infected group. Our findings suggest inflammatory injury of the endothelium, pointing to endothelial dysfunction of never-treated HIV-1-infected South Africans of African ancestry. Although no indication of a prothrombotic state could be detected, there was an indication of accelerated vascular aging and probable early atherosclerosis in the older HIV-infected participants.
感染HIV的个体所患的慢性感染状态会引发慢性动脉炎症和损伤，进而导致内皮功能障碍、动脉粥样硬化和血栓形成。尽管HIV-1 C亚型在南非很普遍，占全球感染病例的近三分之一，但该亚型在基因上与大多数研究针对的HIV-1 B亚型不同。本研究的目的是评估新确诊、从未接受过治疗的HIV-1感染南非参与者是否表现出内皮功能障碍、动脉粥样硬化加速和血液凝固增加的迹象。我们将300名新诊断（从未接受过抗逆转录病毒治疗）的HIV感染参与者与300名年龄、性别、体重指数和居住地点相匹配的未感染对照者进行了比较。测定了高密度脂蛋白胆固醇（HDL-C）、甘油三酯、白细胞介素-6（IL-6）、C反应蛋白（CRP）、细胞间黏附分子-1（ICAM-1）、血管细胞黏附分子-1（VCAM-1）、纤维蛋白原和纤溶酶原激活物抑制剂-1（PAI-1）的水平，以及桡动脉脉搏波速度（cr-PWV）。与未感染对照者相比，HIV感染参与者的HDL-C水平较低，而IL-6、CRP、ICAM-1和VCAM-1水平较高。未检测到纤维蛋白原和PAI-1水平的差异。在HIV感染组中检测到年龄增长与cr-PWV呈持续正相关趋势。我们的研究结果表明存在内皮的炎性损伤，这表明非洲血统的未接受过治疗的HIV-1感染南非人存在内皮功能障碍。尽管未检测到促血栓形成状态的迹象，但在年龄较大的HIV感染参与者中存在血管衰老加速和可能早期动脉粥样硬化的迹象。
