Pirs Mateja, Eržen Barbara, Sabović Mišo, Karner Primož, Vidmar Ludvik, Poljak Mario, Jug Borut, Mikac Mojca, Tomažič Janez
Institute of Microbiology and Immunology, University of Ljubljana, Zaloška 4, 1000, Ljubljana, Slovenia,
Wien Klin Wochenschr. 2014 May;126(9-10):263-9. doi: 10.1007/s00508-014-0516-6. Epub 2014 Mar 21.
Increased life expectancy of human immunodeficiency virus (HIV)-infected patients appears to be coupled with increased incidence of cardiovascular disease (CVD).
The aim of our study was to determine the presence of early atherosclerosis among Slovenian HIV-infected patients below the age of 55 years.
A total of 86 HIV-infected male patients below the age of 55 years participated in our study. Ankle-brachial index (ABI) was measured using a handheld Doppler ultrasonic probe and a blood pressure cuff. Carotid intima-media thickness (CIMT) was assessed by the B-mode high-resolution ultrasound technique. Low ABI, CIMT > 0.8 mm or presence of carotid plaques were considered markers of early atherosclerosis.
Average CIMT was lowest among treatment-naïve patients (0.65 mm); 10 (38.4 %) had CIMT > 0.8 mm, and carotid plaques were detected in 1 (3.8 %). Average CIMT among treated patients was 0.71 mm; 30 (50.0 %) had CIMT > 0.8 mm, and plaques were detected in 11 (18.3 %). Low ABI (≤ 0.90) was found in five patients (5.8 %) without symptoms of peripheral artery disease; two were treatment-naïve, and three received antiretroviral therapy. Early atherosclerosis was found in 43 (50.0 %) patients; 10 (38.4 %) were in treatment-naïve and 33 (55.0 %) in the treated group.
Increased prevalence of early atherosclerosis among Slovenian HIV-infected patients below the age of 55 years has been demonstrated. Screening for early atherosclerosis should be implemented in the evaluation of young HIV-infected patients because a more aggressive treatment approach, aimed to delay the progression of atherosclerosis, may be warranted especially when carotid plaques are detected. We have shown that although ABI contributes to CVD risk assessment, CIMT assessment remains the more sensitive method.
人类免疫缺陷病毒（HIV）感染患者预期寿命的延长似乎与心血管疾病（CVD）发病率的增加相关。
我们研究的目的是确定55岁以下斯洛文尼亚HIV感染患者中早期动脉粥样硬化的存在情况。
共有86名55岁以下的HIV感染男性患者参与了我们的研究。使用手持式多普勒超声探头和血压袖带测量踝臂指数（ABI）。通过B型高分辨率超声技术评估颈动脉内膜中层厚度（CIMT）。低ABI、CIMT>0.8 mm或存在颈动脉斑块被视为早期动脉粥样硬化的标志物。
未接受过治疗的患者平均CIMT最低（0.65 mm）；10名（38.4%）患者CIMT>0.8 mm，1名（3.8%）检测到颈动脉斑块。接受治疗的患者平均CIMT为0.71 mm；30名（50.0%）患者CIMT>0.8 mm，11名（18.3%）检测到斑块。5名（5.8%）无外周动脉疾病症状的患者发现低ABI（≤0.90）；2名未接受过治疗，3名接受抗逆转录病毒治疗。43名（50.0%）患者发现早期动脉粥样硬化；未接受过治疗的患者中有10名（38.4%），治疗组中有33名（55.0%）。
已证实55岁以下斯洛文尼亚HIV感染患者中早期动脉粥样硬化的患病率增加。在年轻HIV感染患者的评估中应进行早期动脉粥样硬化筛查，因为可能需要采取更积极的治疗方法来延缓动脉粥样硬化的进展，尤其是在检测到颈动脉斑块时。我们已经表明，虽然ABI有助于心血管疾病风险评估，但CIMT评估仍然是更敏感的方法。
