Raposeiras-Roubín Sergio, Triant Virginia
Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain.
Massachusetts General Hospital Divisions of General Internal Medicine and Infectious Diseases and Harvard Medical School, Boston, Massachusetts, United States.
Rev Esp Cardiol (Engl Ed). 2016 Dec;69(12):1204-1213. doi: 10.1016/j.rec.2016.10.005. Epub 2016 Nov 10.
Although the incidence of cardiovascular diseases classically associated with human immunodeficiency virus (HIV) has decreased considerably with antiretroviral therapy, cardiovascular risk, and especially ischemic heart disease, are higher in HIV-infected patients than in uninfected individuals. This is due to the interaction of patient-dependent factors with virus-dependent factors, as well as factors associated with antiretroviral therapy. With increasing of life expectancy and the chronicity of HIV infection, cardiovascular disease has emerged as an important cause of morbidity and mortality in HIV patients. In developed countries, the most common cardiovascular manifestation of HIV is ischemic heart disease. Currently, it is not uncommon to find HIV patients with acute coronary syndrome and, given the important pharmacokinetic interactions of antiretroviral drugs, it is important to know which cardiovascular treatments are safe in this group of patients. The ideal approach would be to mitigate the cardiovascular risk in HIV patients with specific primary prevention measures. All these issues are discussed in this review, which aims to aid clinical cardiologists faced with HIV patients with ischemic heart disease or with high cardiovascular risk in daily clinical practice.
尽管经典的与人类免疫缺陷病毒（HIV）相关的心血管疾病发病率在抗逆转录病毒治疗后已大幅下降，但HIV感染患者的心血管风险，尤其是缺血性心脏病风险，高于未感染个体。这是由于患者相关因素与病毒相关因素的相互作用，以及与抗逆转录病毒治疗相关的因素。随着HIV感染者预期寿命的延长和感染的慢性化，心血管疾病已成为HIV患者发病和死亡的重要原因。在发达国家，HIV最常见的心血管表现是缺血性心脏病。目前，HIV患者合并急性冠状动脉综合征并不少见，鉴于抗逆转录病毒药物重要的药代动力学相互作用，了解哪些心血管治疗方法对该组患者是安全的很重要。理想的方法是通过特定的一级预防措施降低HIV患者的心血管风险。本综述讨论了所有这些问题，旨在帮助临床心脏病专家在日常临床实践中面对患有缺血性心脏病或心血管风险高的HIV患者。
