Department of Infectious Diseases, Odense University Hospital, Denmark.
Clin Infect Dis. 2011 Dec;53(11):1156-63. doi: 10.1093/cid/cir675. Epub 2011 Oct 13.
Premature aging has been suggested a risk factor for early death in patients infected with human immunodeficiency virus (HIV). Therefore, the risk of age-related diseases, such as cataracts, should be increased in this population. In a nationwide, population-based cohort study we assessed the risk of cataract surgery in HIV-infected individuals compared with the general population.
We identified 5315 HIV-infected individuals from a Danish national cohort of HIV-infected individuals and a population-based age- and sex-matched comparison cohort of 53,150 individuals. Data on cataract surgery were obtained from the Danish National Hospital registry. Cumulative incidence curves were constructed. Incidence rate ratios (IRRs) and impact of immunodeficiency, highly active antiretroviral therapy (HAART), and treatment with abacavir, tenofovir, protease inhibitors, and nonnucleoside analogue reverse-transcriptase inhibitors (NNRTIs) were estimated by Poisson regression analyses and adjusted for age, sex, and calendar year.
HIV-infected individuals had a higher risk of cataract surgery than the comparison cohort (adjusted IRR, 1.87; 95% confidence interval (CI): 1.50-2.33). The highest risk was found in patients with a CD4 cell count ≤ 200 cells/μL (adjusted IRR before HAART initiation, 3.11 [95% CI, 1.26-7.63]; adjusted IRR after HAART initiation, 4.74 [95% CI, 2.60-8.62]). In patients not receiving HAART and those receiving HAART with a CD4 cell count >200 cells/mL the adjusted IRRs were 0.60 (95% CI: 0.22-1.61) and 1.87 (95% CI: 1.46-2.39). Treatment with abacavir, tenofovir, protease inhibitors, or NNRTIs did not increase the risk substantially.
HIV-infected individuals have an increased risk of cataract surgery. The risk is mainly associated with immunodeficiency and HAART, but accelerated aging cannot be excluded as part of the possible explanation.
有人提出，早衰是感染人类免疫缺陷病毒（HIV）患者早逝的一个风险因素。因此，该人群罹患白内障等与年龄相关疾病的风险应该会增加。在这项全国性、基于人群的队列研究中，我们评估了与普通人群相比，HIV 感染者行白内障手术的风险。
我们从丹麦的一个 HIV 感染者全国队列和一个与年龄及性别相匹配的 53150 人的普通人群对照队列中确定了 5315 名 HIV 感染者。白内障手术数据来自丹麦全国医院登记处。构建了累积发病率曲线。采用泊松回归分析估计发病率比（IRR）和免疫缺陷、高效抗逆转录病毒治疗（HAART）以及阿巴卡韦、替诺福韦、蛋白酶抑制剂和非核苷类逆转录酶抑制剂（NNRTIs）治疗的影响，并根据年龄、性别和日历年份进行了调整。
与对照队列相比，HIV 感染者行白内障手术的风险更高（校正 IRR，1.87；95%置信区间[CI]：1.50-2.33）。在 CD4 细胞计数≤200 个/μL 的患者中风险最高（HAART 治疗前校正 IRR，3.11[95%CI，1.26-7.63]；HAART 治疗后校正 IRR，4.74[95%CI，2.60-8.62]）。未接受 HAART 治疗的患者和接受 HAART 治疗且 CD4 细胞计数>200 个/μL 的患者的校正 IRR 分别为 0.60（95%CI：0.22-1.61）和 1.87（95%CI：1.46-2.39）。阿巴卡韦、替诺福韦、蛋白酶抑制剂或 NNRTIs 的治疗并未显著增加风险。
HIV 感染者行白内障手术的风险增加。该风险主要与免疫缺陷和 HAART 相关，但不能排除加速衰老也是可能的解释之一。
