Kim Sun Bean, Kim Yong Chan, Kim Min Hyung, Song Je Eun, Oh Dong Hyun, Ahn Jin Young, Ku Nam Su, Kim Hye-Won, Jeong Su Jin, Han Sang Hoon, Song Young Goo, Choi Jun Yong, Kim June Myung
From the Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine , Seoul , Republic of Korea.
Scand J Infect Dis. 2013 Nov;45(11):855-62. doi: 10.3109/00365548.2013.813064. Epub 2013 Aug 23.
The introduction of highly active antiretroviral therapy (HAART) has extended the life expectancy of persons infected with the human immunodeficiency virus type 1 (HIV-1). However, cardiovascular disease (CVD) is currently an increasing concern for HIV-infected persons.
We conducted a cross-sectional case-control study to evaluate and compare the 10-y cardiovascular risk of HIV-infected Koreans who had been receiving HAART for over 6 months and age- and sex-matched uninfected persons who visited a health promotion center, by calculating Framingham risk scores (FRS).
The average 10-y risk for cardiovascular events (FRS) was 7.07% (2-45) in the HIV group and 6.87% (1-37) in the control group (p = 0.77), corresponding to the very low risk group. Among HIV patients, the FRS was above 10% (low to moderate cardiovascular risk) in 19.9% of the patients, and above 20% (high risk) in 1.7% of the patients. In the healthy control group, the FRS was above 10% in 16.8% and above 20% in 2.7% (p = 0.57). The FRS was not significantly different for HIV-infected patients treated with protease inhibitor (PI)-based HAART and those treated with non-nucleoside reverse transcriptase inhibitor (NNRTI)-based HAART (7.26 ± 6.3 and 6.81 ± 4.4, respectively, p = 0.69).
The predicted cardiovascular risk of HIV-infected Koreans on HAART by FRS equation was low and similar to that of age- and sex-matched healthy control persons. However, the possibility remains that actual cardiovascular events could be underestimated. The next step for predicting the cardiovascular risk is to calculate the Data Collection of Adverse Events of Anti-HIV Drugs (D:A:D) equation risks.
高效抗逆转录病毒疗法（HAART）的引入延长了感染人类免疫缺陷病毒1型（HIV-1）者的预期寿命。然而，心血管疾病（CVD）目前是HIV感染者日益关注的问题。
我们进行了一项横断面病例对照研究，通过计算弗明汉风险评分（FRS）来评估和比较接受HAART超过6个月的韩国HIV感染者与年龄和性别匹配的未感染且前往健康促进中心的人群的10年心血管风险。
HIV组心血管事件的平均10年风险（FRS）为7.07%（2 - 45），对照组为6.87%（1 - 37）（p = 0.77），均对应极低风险组。在HIV患者中，19.9%的患者FRS高于10%（低至中度心血管风险），1.7%的患者FRS高于20%（高风险）。在健康对照组中，16.8%的人FRS高于10%，2.7%的人FRS高于20%（p = 0.57）。接受基于蛋白酶抑制剂（PI）的HAART治疗的HIV感染患者与接受基于非核苷类逆转录酶抑制剂（NNRTI）的HAART治疗的患者的FRS无显著差异（分别为7.26±6.3和6.81±4.4，p = 0.69）。
通过FRS方程预测的接受HAART的韩国HIV感染者的心血管风险较低，与年龄和性别匹配的健康对照人群相似。然而，实际心血管事件仍有可能被低估。预测心血管风险的下一步是计算抗HIV药物不良事件数据收集（D:A:D）方程风险。
