Sawadogo A, Sanou S, Hema A, Kamboule B E, Kabore N F, Sore I, Konate A, Poda G E A, Zoungrana J, Sawadogo A B
Service d'hépato-gastro-entérologie du CHU Sanou Sourô (CHUSS), 01 BP 676, Bobo-Dioulasso 01, Burkina Faso,
Bull Soc Pathol Exot. 2014 Aug;107(3):151-8. doi: 10.1007/s13149-014-0371-8. Epub 2014 Jun 23.
Highly active antiretroviral therapy (HAART) has reduced morbidity and mortality of HIV but has led to an increasing metabolic cardiovascular risk. A cross-sectional study was conducted from May to September 2011 in Day Care Hospital for HIV-Patients of Bobo-Dioulasso. We included in this study 400 patients infected by HIVon antiretroviral therapy ≥ 6 months selected by a random draw. Metabolic syndrome was assessed according to the definitions of the IDF and ATP-III. The high risk of cardiovascular disease in 10 years was defined by a Framingham score ≥ 20%. The average age of our patients was 41.4 years [20-76]. 17% received an IP. The average duration of PI exposure was 35.5 months and 50.1 months for NNRTI. The prevalence of diabetes was 1.3% (95% CI: 0.5-3) and that of hypertension of 12.0 % (95% CI: 9.3-16). The prevalence of metabolic syndrome according to IDF was 10% (95% CI: 7.3-13.5) and the metabolic syndrome according to ATP-III 12.3% (95% CI: 9.3-16). The body mass index was higher (BMI 25.2 vs. 22.5 kg/m(2), p <10(-3) with ATPIII and BMI 26.6 vs. 22.4 kg/m(2), p <10(-3) with IDF), and duration exposure to ARVs longer in patients with metabolic syndrome regardless of the definition used (58.6 months vs 27.9 months). High cardiovascular risk was present in 1.8% (95% CI: 0.8 to 3.7) of our patients, all male more than half (n=4/7) of them were smoking. The choice of antiretroviral therapy must take into account its potential long-term toxicity. It should also strengthen supervision.
高效抗逆转录病毒疗法(HAART)降低了HIV的发病率和死亡率,但却导致代谢性心血管疾病风险增加。2011年5月至9月,在博博迪乌拉索的HIV患者日间护理医院进行了一项横断面研究。本研究纳入了400例接受抗逆转录病毒治疗≥6个月的HIV感染者,通过随机抽签选定。根据国际糖尿病联盟(IDF)和美国国家胆固醇教育计划成人治疗组第三次报告(ATP-III)的定义评估代谢综合征。10年心血管疾病高风险由弗明汉评分≥20%定义。我们患者的平均年龄为41.4岁[20 - 76岁]。17%的患者接受蛋白酶抑制剂(PI)治疗。PI暴露的平均时长为35.5个月,非核苷类逆转录酶抑制剂(NNRTI)为50.1个月。糖尿病患病率为1.3%(95%置信区间:0.5 - 3),高血压患病率为12.0%(95%置信区间:9.3 - 16)。根据IDF定义的代谢综合征患病率为10%(95%置信区间:7.3 - 13.5),根据ATP-III定义的代谢综合征患病率为12.3%(95%置信区间:9.3 - 16)。体重指数更高(ATP-III标准下,体重指数为25.2 vs. 22.5 kg/m²,p < 10⁻³;IDF标准下,体重指数为26.6 vs. 22.4 kg/m²,p < 10⁻³),且无论采用何种定义,代谢综合征患者的抗逆转录病毒药物暴露时长更长(58.6个月 vs 27.9个月)。1.8%(95%置信区间:0.8至3.7)的患者存在心血管高风险,其中所有男性患者中超过一半(n = 4/7)吸烟。抗逆转录病毒治疗方案的选择必须考虑其潜在的长期毒性。还应加强监测。