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马拉维若治疗对HIV-1/HCV合并感染患者颈动脉内膜中层厚度的影响

Effects of Therapy with Maraviroc on the Carotid Intima Media Thickness in HIV-1/HCV Co-infected Patients.

作者信息

Maggi Paolo, Bruno Giuseppe, Perilli Francesco, Saracino Annalisa, Volpe Anna, Santoro Carmen, Ladisa Nicoletta, Angarano Gioacchino

机构信息

Institute of Infectious Diseases, University of Bari, Bari, Italy

Institute of Infectious Diseases, University of Bari, Bari, Italy.

出版信息

In Vivo. 2017 Jan 2;31(1):125-131. doi: 10.21873/invivo.11035.

Abstract

AIM

To evaluate, in human immunodeficiency virus-hepatitis C virus co-infected patients, the impact of C-C chemokine receptor type 5 (CCR5) antagonist maraviroc-based antiretroviral therapy on the carotid intima media thickness and on atheromasic plaques.

PATIENTS AND METHODS

In this pilot prospective study, 12 HIV-HCV co-infected patients underwent color-Doppler ultrasonography before and 48 weeks after switching to a dual therapy based on maraviroc plus protease inhibitors boosted with ritonavir. Changes of intima media thickness, inflammatory and endothelial adhesion biomarkers levels, Veterans Aging Cohort Study index and Framingham risk score were evaluated.

RESULTS

At baseline 11 (91.6%) patients showed pathological ultrasonographic findings. After 48 weeks, two patients showed an amelioration of intima media thickness. Of the remaining patients with plaques, four showed a reduction of the previously diagnosed plaque; no patients worsened.

CONCLUSION

Our data suggest that CCR5 inhibition could reduce the development of atherosclerosis especially in the non-calcific stage and could play an important role in the blockade of atheromasic plaque progression.

摘要

目的

在人类免疫缺陷病毒-丙型肝炎病毒合并感染患者中,评估基于C-C趋化因子受体5(CCR5)拮抗剂马拉维若的抗逆转录病毒疗法对颈动脉内膜中层厚度和动脉粥样硬化斑块的影响。

患者与方法

在这项前瞻性试点研究中,12例人类免疫缺陷病毒-丙型肝炎病毒合并感染患者在换用基于马拉维若加用利托那韦增强的蛋白酶抑制剂的联合疗法前及治疗48周后接受了彩色多普勒超声检查。评估内膜中层厚度、炎症和内皮黏附生物标志物水平、退伍军人老龄化队列研究指数和弗雷明汉风险评分的变化。

结果

基线时11例(91.6%)患者显示超声检查结果异常。48周后,2例患者内膜中层厚度有所改善。在其余有斑块的患者中,4例患者先前诊断的斑块有所缩小;无患者病情恶化。

结论

我们的数据表明,CCR5抑制可能会减少动脉粥样硬化的发展,尤其是在非钙化阶段,并且在阻断动脉粥样硬化斑块进展方面可能发挥重要作用。

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