Krikke M, Arends J E, Van Lelyveld Sfl, Hoepelman Aim, Visseren Flj
Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.
Department of Internal Medicine & Gastroenterology, Spaarne Gasthuis, Haarlem, The Netherlands.
HIV Med. 2017 Apr;18(4):275-283. doi: 10.1111/hiv.12428. Epub 2016 Aug 1.
In contrast to the general population, no decline in cardiovascular disease (CVD) has been noted in HIV-infected patients over the last 10 years. We compared the carotid artery intima media thickness (CIMT) of HIV-infected patients to that of age- and gender-matched reference values and determined the relationship between CVD risk factors and CIMT.
A total of 292 HIV-infected patients were enrolled in the study. Data collected included vascular screening data, data obtained using a questionnaire, data obtained from laboratory assessments and CIMT measurement. Using linear regression (adjusted for age/gender/known HIV), the association between HIV-specific and classical cardiovascular risk factors and CIMT was evaluated.
The cohort comprised for 91% of male patients, aged 49.4 ± 10.5 years, with a known duration of HIV infection of 8.8 ± 6.7 years. The mean with standard deviation (mean ± SD) CIMT was 0.77 ± 0.19 mm, compared with 0.58 ± 0.05 mm in the controls. A steeper increase of CIMT per age was seen in the HIV-infected patients. A significant relationship between CIMT and hypertension, diabetes mellitus, smoking, systolic blood pressure, HbA1c (glycated hemoglobin) and ankle brachial index was found. Of the HIV-specific variables, only a relationship between CIMT and length of cART use and between CIMT and (inversely) current cART use was seen.
A greater CIMT was found in HIV-infected patients compared with controls. In contrast to HIV-specific variables, classical CVD risk factors were associated with a greater CIMT and should therefore be the focus of preventive measures.
与普通人群不同，在过去10年中，未发现HIV感染患者的心血管疾病（CVD）有所下降。我们将HIV感染患者的颈动脉内膜中层厚度（CIMT）与年龄和性别匹配的参考值进行比较，并确定CVD危险因素与CIMT之间的关系。
共有292名HIV感染患者纳入本研究。收集的数据包括血管筛查数据、通过问卷获得的数据、实验室评估获得的数据以及CIMT测量值。使用线性回归（根据年龄/性别/已知HIV进行调整），评估HIV特异性和经典心血管危险因素与CIMT之间的关联。
该队列中男性患者占91%，年龄为49.4±10.5岁，已知HIV感染持续时间为8.8±6.7年。CIMT的平均值±标准差为0.77±0.19mm，而对照组为0.58±0.05mm。HIV感染患者的CIMT随年龄增长的幅度更大。发现CIMT与高血压、糖尿病、吸烟、收缩压、糖化血红蛋白（HbA1c）和踝臂指数之间存在显著关系。在HIV特异性变量中，仅发现CIMT与抗逆转录病毒治疗（cART）使用时长以及CIMT与（呈负相关）当前cART使用情况之间存在关系。
与对照组相比，HIV感染患者的CIMT更大。与HIV特异性变量不同，经典的CVD危险因素与更大的CIMT相关，因此应成为预防措施的重点。
