Zhou Danai Tavonga, Kodogo Vitaris, Chokuona Kudzai Fortunate Vongai, Gomo Exnevia, Oektedalen Olav, Stray-Pedersen Babill
Department of Medical Laboratory Sciences, College of Health Sciences, University of Zimbabwe, Avondale, Zimbabwe ; Institute of Clinical Medicine, University in Oslo, Oslo University Hospital, Oslo, Norway.
Department of Medical Laboratory Sciences, College of Health Sciences, University of Zimbabwe, Avondale, Zimbabwe.
HIV AIDS (Auckl). 2015 May 13;7:145-55. doi: 10.2147/HIV.S78523. eCollection 2015.
The chronic inflammation induced by human immunodeficiency virus (HIV) contributes to increased risk of coronary heart disease (CHD) in HIV-infected individuals. HIV-infected patients generally benefit from being treated with antiretroviral drugs, but some antiretroviral agents have side effects, such as dyslipidemia and hyperglycemia. There is general consensus that antiretroviral drugs induce a long-term risk of CHD, although the levels of that risk are somewhat controversial. The intention of this cross-sectional study was to describe the lipid profile and the long-term risk of CHD among HIV-positive outpatients at an HIV treatment clinic in Harare, Zimbabwe. Two hundred and fifteen patients were investigated (females n=165, mean age 39.8 years; males n=50; mean age 42.0 years). Thirty of the individuals were antiretroviral-naïve and 185 had been on antiretroviral therapy (ART) for a mean 3.9±3.4 years. All participants had average lipid and glucose values within normal ranges, but there was a small difference between the ART and ART-for total cholesterol (TC) and high-density lipoprotein (HDL). Those on a combination of D4T or ZDV/NVP/3TC and PI-based ART were on average oldest and had the highest TC levels. Framingham risk showed 1.4% prevalence of high CHD risk within the next ten years. After univariate analysis age, sex, TC/HDL ratio, HDL, economic earnings and systolic BP were associated with medium to high risk of CHD. After multivariate regression analysis and adjusting for age or sex only age, sex and economic earnings were associated with medium to high risk of CHD. There is small risk of developing CHD, during the next decade in HIV infected patients at an HIV treatment clinic in Harare.
人类免疫缺陷病毒（HIV）引发的慢性炎症会增加HIV感染者患冠心病（CHD）的风险。HIV感染患者通常会从抗逆转录病毒药物治疗中获益，但一些抗逆转录病毒药物有副作用，如血脂异常和高血糖。尽管这种风险的程度存在一定争议，但人们普遍认为抗逆转录病毒药物会引发患冠心病的长期风险。这项横断面研究的目的是描述津巴布韦哈拉雷一家HIV治疗诊所中HIV阳性门诊患者的血脂情况和患冠心病的长期风险。对215名患者进行了调查（女性n = 165，平均年龄39.8岁；男性n = 50，平均年龄42.0岁）。其中30人未接受过抗逆转录病毒治疗，185人接受抗逆转录病毒治疗（ART）的平均时间为3.9±3.4年。所有参与者的血脂和血糖值均在正常范围内，但接受ART治疗者与未接受ART治疗者在总胆固醇（TC）和高密度脂蛋白（HDL）方面存在细微差异。接受D4T或ZDV/NVP/3TC与基于蛋白酶抑制剂（PI）的联合ART治疗的患者平均年龄最大，TC水平最高。弗明汉风险评估显示，未来十年内患冠心病高风险的患病率为1.4%。单因素分析后发现，年龄、性别、TC/HDL比值、HDL、经济收入和收缩压与患冠心病的中高风险相关。多因素回归分析并仅对年龄或性别进行调整后，只有年龄、性别和经济收入与患冠心病的中高风险相关。在哈拉雷一家HIV治疗诊所中，HIV感染患者在未来十年患冠心病的风险较小。
