Faculdade de Ciências Médicas, Universidade de Pernambuco, Brazil.
Arq Bras Cardiol. 2011 Nov;97(5):427-33. doi: 10.1590/s0066-782x2011005000094. Epub 2011 Sep 30.
Antiretroviral therapy has dramatically increased life expectancy in patients with HIV/AIDS although atherosclerosis has been associated with long-standing therapy.
To investigate the prevalence of atherosclerosis in patients with AIDS undergoing antiretroviral therapy and the influence of different schemes and duration of treatment.
HIV/AIDS patients were approached during routine consultations. Those who had been on antiretroviral therapy for at least two years had their blood collected for analysis of lipid profile and fasting glycemia and underwent cardiac CT for quantification of calcium score within six days at the most. Atherosclerosis was defined as calcium score greater than zero (CAC > 0). Traditional risk factors, metabolic syndrome and Framingham score were analyzed.
Fifty-three patients performed cardiac CT. Twenty-seven (50.94%) were male, mean age 43.4 years; 20.00% had hypertension, 3.77% diabetes, 67.92% hypercholesterolemia, 37.74% hypertriglyceridemia and 47.17% low HDL. Thirteen (24.53%) met criteria for metabolic syndrome and 96.23% were classified in Framingham score as "low risk." Ten patients (18.87%) were smokers. Mean duration of antiretroviral treatment was 58.98 months. Coronary atherosclerosis occurred in 11 (20.75%) patients. Duration of antiretroviral therapy was not related to atherosclerosis (p = 0.41) and there were no significant differences between different antiretroviral regimens (p = 0.71). Among traditional risk factors, smoking (OR = 27.20; p = 0.023) and age (OR = 20.59; p = 0.033) were significant in the presence of atherosclerosis. There was a trend towards a positive association of atherosclerosis with hypercholesterolemia (OR = 8.30; p = 0.0668).
Factors associated with atherosclerosis were age, smoking and hypercholesterolemia. Duration and type of antiretroviral therapy had no influence on the prevalence of atherosclerosis.
抗逆转录病毒疗法显著提高了 HIV/AIDS 患者的预期寿命，但动脉粥样硬化与长期治疗有关。
研究接受抗逆转录病毒治疗的艾滋病患者的动脉粥样硬化患病率以及不同方案和治疗时间的影响。
在常规就诊期间接触 HIV/AIDS 患者。那些已经接受抗逆转录病毒治疗至少两年的患者，在最多六天内采集血液进行血脂谱和空腹血糖分析，并进行心脏 CT 以定量钙评分。动脉粥样硬化定义为钙评分大于零（CAC > 0）。分析了传统危险因素、代谢综合征和弗雷明汉评分。
53 名患者进行了心脏 CT 检查。27 名（50.94%）为男性，平均年龄 43.4 岁；20.00%有高血压，3.77%有糖尿病，67.92%有高胆固醇血症，37.74%有高甘油三酯血症，47.17%有低高密度脂蛋白。13 名（24.53%）符合代谢综合征标准，96.23%的人被归类为弗雷明汉评分的“低风险”。10 名（18.87%）患者为吸烟者。抗逆转录病毒治疗的平均持续时间为 58.98 个月。11 名（20.75%）患者发生冠状动脉粥样硬化。抗逆转录病毒治疗时间与动脉粥样硬化无关（p = 0.41），不同抗逆转录病毒方案之间无显著差异（p = 0.71）。在传统危险因素中，吸烟（OR = 27.20；p = 0.023）和年龄（OR = 20.59；p = 0.033）在存在动脉粥样硬化时具有显著意义。动脉粥样硬化与高胆固醇血症呈正相关趋势（OR = 8.30；p = 0.0668）。
与动脉粥样硬化相关的因素是年龄、吸烟和高胆固醇血症。抗逆转录病毒治疗的持续时间和类型对动脉粥样硬化的患病率没有影响。
