接受抗逆转录病毒治疗的人类免疫缺陷病毒感染患者中同型半胱氨酸水平升高：一项荟萃分析。
Elevated homocysteine levels in human immunodeficiency virus-infected patients under antiretroviral therapy: A meta-analysis.
作者信息
Deminice Rafael, Silva Talita Capoani Vieira, de Oliveira Vitor Hugo Fernando
机构信息
Rafael Deminice, Talita Capoani Vieira Silva, Vitor Hugo Fernando de Oliveira, Department of Physical Education, State University of Londrina, Londrina 86057-970, Brazil.
出版信息
World J Virol. 2015 May 12;4(2):147-55. doi: 10.5501/wjv.v4.i2.147.
AIM
To evaluate the association between the levels of homocysteine (Hcy), folate, vitamin B12 in human immunodeficiency virus (HIV)-infected patients who were treated with antiretroviral therapy (ART) or not treated with ART.
METHODS
The PubMed and Scielo databases were searched. Eligible studies regarding plasma Hcy level in HIV-infected patients were firstly identified. After careful analysis by two independent researches, the identified articles were included in the review according to two outcomes (1) Hcy, folate and vitamin B12 blood concentration in HIV-infected subjects vs health controls and; (2) Hcy blood concentration in HIV-infected subjects under ART vs not treated with ART. RevMan (version 5.2) was employed for data synthesis.
RESULTS
A total of 12 studies were included in outcome 1 (1649 participants, 932 cases and 717 controls). Outcome 1 meta-analysis demonstrated higher plasma Hcy (2.05 µmol/L; 95%CI: 0.10 to 4.00, P < 0.01) and decreased plasma folate concentrations (-2.74 ng/mL; 95%CI: -5.18 to -0.29, P < 0.01) in HIV-infected patients compared to healthy controls. No changes in vitamin B12 plasma concentration were observed between groups. All studies included in the outcome 2 meta-analysis (1167 participants; 404 HIV-infected exposed to ART and 757 HIV-infected non-ART patients) demonstrated higher mean Hcy concentration in subjects HIV-infected under ART compared to non-ART HIV subjects (4.13 µmol/L; 95%CI: 1.34 to 6.92, P < 0.01).
CONCLUSION
This meta-analysis demonstrated that the levels of Hcy and folate, but not vitamin B12, were associated with HIV infection. In addition, Hcy levels were higher in HIV-infected patients who were under ART compared to HIV-infected patients who were not exposed to ART. Our results suggest that hyperhomocysteinemia should be included among the several important metabolic disturbances that are associated with ART in patients with HIV infection.
目的
评估接受抗逆转录病毒治疗（ART）或未接受ART治疗的人类免疫缺陷病毒（HIV）感染患者的同型半胱氨酸（Hcy）、叶酸、维生素B12水平之间的关联。
方法
检索PubMed和Scielo数据库。首先确定有关HIV感染患者血浆Hcy水平的符合条件的研究。经过两名独立研究人员的仔细分析，根据两个结果将确定的文章纳入综述：（1）HIV感染受试者与健康对照者的Hcy、叶酸和维生素B12血液浓度；以及（2）接受ART治疗的HIV感染受试者与未接受ART治疗的HIV感染受试者的Hcy血液浓度。采用RevMan（5.2版）进行数据合成。
结果
结果1纳入了12项研究（1649名参与者，932例病例和717名对照）。结果1的荟萃分析表明，与健康对照者相比，HIV感染患者的血浆Hcy水平更高（2.05µmol/L；95%CI：0.10至4.00，P<0.01），血浆叶酸浓度降低（-2.74ng/mL；95%CI：-5.18至-0.29，P<0.01）。两组之间未观察到维生素B12血浆浓度的变化。结果2的荟萃分析纳入的所有研究（1167名参与者；404名接受ART治疗的HIV感染者和757名未接受ART治疗的HIV感染者）表明，与未接受ART治疗的HIV感染者相比，接受ART治疗的HIV感染者的平均Hcy浓度更高（4.13µmol/L；95%CI：1.34至6.92，P<0.01）。
结论
这项荟萃分析表明，Hcy和叶酸水平与HIV感染有关，而维生素B12水平与HIV感染无关。此外，与未接受ART治疗的HIV感染患者相比，接受ART治疗的HIV感染患者的Hcy水平更高。我们的结果表明，高同型半胱氨酸血症应被纳入与HIV感染患者ART相关的几种重要代谢紊乱之中。
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