Tripathi Avnish, Jerrell Jeanette M, Skelton Thomas N, Nickels Myrna A, Duffus Wayne A
Division of Internal Medicine, Department of Medicine, University of Mississippi School of Medicine, Jackson, MS, USA.
Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, SC, USA.
J Am Soc Hypertens. 2015 May;9(5):351-7. doi: 10.1016/j.jash.2015.01.007. Epub 2015 Jan 19.
Literature remains scarce on the impact of antiretroviral medications on hypertension in the HIV population. We used the South Carolina Medicaid database linked with the enhanced HIV/AIDS system surveillance database for 1994-2011 to evaluate incident hypertension and the impact of combination antiretroviral therapy (cART) in HIV/AIDS population compared with a propensity- matched non-HIV control group. Multivariable, time-dependent survival analysis suggested no significant difference in incidence of hypertension between the HIV group and the non-HIV control group. However, subgroup analysis suggested that among the HIV-infected group, months of exposure to both non-nucleoside reverse transcriptase inhibitors (adjusted hazard ratio, 1.52; 95% confidence interval, 1.3-1.75) and protease inhibitors (adjusted hazard ratio, 1.26; 95% confidence interval, 1.11-1.44) were associated with an increased risk of incident hypertension after adjusting for traditional demographic and metabolic risk factors. In people with HIV/AIDS, prolonged exposure to both protease inhibitor-based and non-nucleoside reverse transcriptase inhibitor-based cART may increase the risk of incident hypertension.
关于抗逆转录病毒药物对HIV感染者高血压影响的文献仍然很少。我们利用1994年至2011年南卡罗来纳州医疗补助数据库与强化HIV/艾滋病系统监测数据库相链接的数据，评估HIV/艾滋病人群中高血压的发病率以及与倾向匹配的非HIV对照组相比联合抗逆转录病毒疗法（cART）的影响。多变量、时间依赖性生存分析表明，HIV组和非HIV对照组之间高血压发病率无显著差异。然而，亚组分析表明，在HIV感染组中，在调整了传统人口统计学和代谢风险因素后，暴露于非核苷类逆转录酶抑制剂的月数（调整后的风险比为1.52；95%置信区间为1.3 - 1.75）和蛋白酶抑制剂的月数（调整后的风险比为1.26；95%置信区间为1.11 - 1.44）均与高血压发病风险增加相关。在HIV/AIDS患者中，长期暴露于基于蛋白酶抑制剂和基于非核苷类逆转录酶抑制剂的cART可能会增加高血压发病风险。
