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HIV 感染者的动脉僵硬度与 HIV 相关因素有关吗?

Is arterial stiffness in HIV-infected individuals associated with HIV-related factors?

机构信息

Serviço de Doenças Infecciosas, Universidade de Pernambuco, Recife, PE, Brasil.

出版信息

Braz J Med Biol Res. 2012 Sep;45(9):818-26. doi: 10.1590/s0100-879x2012007500116. Epub 2012 Jul 12.

Abstract

We investigated the association between pulse wave velocity (PWV) and HIV infection, antiretroviral treatment-related characteristics, viral load, immune status, and metabolic changes in a cross-sectional study nested in a cohort of HIV/AIDS patients who have been followed for metabolic and cardiovascular changes since 2007. The study included patients recruited from the cohort (N = 261) and a comparison group (N = 82) of uninfected individuals, all enrolled from April to November 2009. Aortic stiffness was estimated using the carotid-femoral PWV (Complior-Artech, Paris, France). The groups were similar with respect to age, metabolic syndrome, diabetes mellitus, Framingham score, and use of antihypertensive and hypolipidemic medications. Hypertension was more frequent among the controls. Individuals with HIV had higher triglyceride, glucose and HDL cholesterol levels. Among individuals with HIV/AIDS, those with a nadir CD4+ T-cell count <200 cells/mm³ had a higher PWV (P = 0.01). There was no statistically significant difference when subjects were stratified by gender. Heart rate, age, male gender, and blood pressure were independently correlated with PWV. Nadir CD4+ T-cell count did not remain in the final model. There was no significance difference in PWV between HIV-infected individuals and uninfected controls. PWV was correlated with age, gender, and blood pressure across the entire population and among those infected with HIV. We recommend cohort studies to further explore the association between inflammation related to HIV infection and/or immune reconstitution and antiretroviral use and PWV.

摘要

我们在一项横断研究中调查了脉搏波速度(PWV)与 HIV 感染、抗逆转录病毒治疗相关特征、病毒载量、免疫状态和代谢变化之间的关系,该研究嵌套在 2007 年开始对 HIV/AIDS 患者进行代谢和心血管变化随访的队列中。该研究包括从队列(N=261)和未感染对照(N=82)中招募的患者,均于 2009 年 4 月至 11 月期间入组。使用颈股 PWV(Complior-Artech,巴黎,法国)估计主动脉僵硬度。两组在年龄、代谢综合征、糖尿病、Framingham 评分以及使用抗高血压和降血脂药物方面相似。对照组中高血压更为常见。HIV 感染者的甘油三酯、葡萄糖和高密度脂蛋白胆固醇水平较高。在 HIV/AIDS 患者中,CD4+T 细胞计数最低点<200 个/毫米³的患者 PWV 更高(P=0.01)。按性别分层时,无统计学差异。心率、年龄、男性和血压与 PWV 独立相关。CD4+T 细胞计数最低点未保留在最终模型中。HIV 感染者与未感染者之间的 PWV 无显著差异。PWV 与整个人群以及感染 HIV 的人群中的年龄、性别和血压相关。我们建议进行队列研究以进一步探讨与 HIV 感染和/或免疫重建以及抗逆转录病毒使用相关的炎症与 PWV 之间的关系。

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