Masiá Mar, Pérez-Cachafeiro Santiago, Leyes María, López-Aldeguer José, López Mariola, Segura Ferrán, Blanco José Ramón, Peña Alejandro, Rodríguez Francisco, Vera Mar, Del Amo Julia, Gutiérrez Félix
Hospital General Universitario de Elche, Universidad Miguel Hernández, Elche, España.
Enferm Infecc Microbiol Clin. 2012 Nov;30(9):517-27. doi: 10.1016/j.eimc.2012.02.014. Epub 2012 Apr 30.
Current information on cardiovascular risk (CVR) in HIV-infected patients in Spain is limited.
An analysis was made of a prospective multicentre cohort of Spanish HIV-infected patients (CoRIS) between January-2010 and July-2011. CVR was evaluated using Framingham, REGICOR and SCORE equations.
The study included 1019 patients (76% males, mean age 40 years) recruited from 13 hospitals belonging to 10 autonomous communities in Spain. Almost two-thirds (65.4%) of patients were on antiretroviral therapy (ART), 36.7% with non-nucleoside analogs, 24% with protease inhibitors (PIs) (52% with atazanavir/r or darunavir/r) and 4,6% with raltegravir. More than half (56.2%) of the patients had an HIV viral load <50 copies/ml. Smoking prevalence was 46%, HDL cholesterol (HDL-C) <40mg/dl 36.1%, total cholesterol (total-C) >200mg/dl 27.8%, age >45years 27.2%, metabolic syndrome 11.5%, hypertension 9.4%, cocaine use 7%, and diabetes 2.9%. ART was associated with higher total-C and LDL-C concentrations, although also higher HDL-C and lower total-C/HDL-C ratio; patients receiving PIs boosted with a high ritonavir dose showed higher total-C levels and higher total-C/HDL-C ratio. According to Framingham cardiovascular, and coronary, REGICOR, and SCORE equations, 15.2%, 6.4%, 4.2% and 3.9% of patients, respectively, were classified as having moderate or high CVR.
In HIV-infected patients from CoRIS, prevalence of modifiable CVR factors is still high. Commonly used scores identify a relatively low number of patients with high CVR.
西班牙艾滋病毒感染患者心血管风险（CVR）的现有信息有限。
对2010年1月至2011年7月期间西班牙艾滋病毒感染患者的前瞻性多中心队列（CoRIS）进行了分析。使用弗明汉姆、REGICOR和SCORE方程评估CVR。
该研究纳入了1019名患者（76%为男性，平均年龄40岁），这些患者来自西班牙10个自治区的13家医院。近三分之二（65.4%）的患者接受抗逆转录病毒治疗（ART），36.7%使用非核苷类似物，24%使用蛋白酶抑制剂（PI）（52%使用阿扎那韦/利托那韦或达芦那韦/利托那韦），4.6%使用拉替拉韦。超过一半（56.2%）的患者艾滋病毒载量<50拷贝/毫升。吸烟率为46%，高密度脂蛋白胆固醇（HDL-C）<40mg/dl为36.1%，总胆固醇（total-C）>200mg/dl为27.8%，年龄>45岁为27.2%，代谢综合征为11.5%，高血压为9.4%，使用可卡因率为7%，糖尿病为2.9%。ART与较高的总胆固醇和低密度脂蛋白胆固醇浓度相关，尽管同时也有较高的HDL-C和较低的总胆固醇/HDL-C比值；接受高剂量利托那韦增强的PI治疗的患者总胆固醇水平较高，总胆固醇/HDL-C比值也较高。根据弗明汉姆心血管、冠心病、REGICOR和SCORE方程，分别有15.2%、6.4%、4.2%和3.9%的患者被归类为具有中度或高度CVR。
在CoRIS队列的艾滋病毒感染患者中，可改变的CVR因素患病率仍然很高。常用评分识别出的高CVR患者数量相对较少。
