CHIP (Centre of Excellence for Health, Immunity and Infections), Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Curr Opin HIV AIDS. 2017 Nov;12(6):594-603. doi: 10.1097/COH.0000000000000417.
The aim of this study was to discuss the most recent research in the management of cardiovascular disease (CVD) in people living with HIV (PLWHIV) with a focus on screening, primary and secondary prevention.
The cause of CVD in PLWHIV is complex and multifactorial and creates a demand for a multifaceted approach to screening and prevention. Current screening and management of CVD risk factors in PLWHIV is suboptimal, reasons for this are not clear and the data are still scarce both in the primary and secondary preventive setting. There are no optimal routine risk screening tools available to accurately detect early and subclinical disease; PLWHIV are undertreated with preventive drugs such as statins and aspirin and antihypertensives; there are still no programmes that have been shown significantly efficient over time with regards to improved smoking cessation, increased physical activity and optimal diet, and recent reports call for intensified focus on HIV-positive women as a particularly vulnerable subgroup.
There is a need for further studies investigating barriers to optimal CVD risk factor management in PLWHIV and an increased focus of CVD prevention in HIV-positive women.
本研究旨在讨论目前针对 HIV 感染者（PLWHIV）心血管疾病（CVD）管理的最新研究进展，重点讨论筛查、一级和二级预防。
PLWHIV 中 CVD 的病因复杂且多因素，这就需要采用多方面的方法进行筛查和预防。目前，PLWHIV 的 CVD 风险因素筛查和管理并不理想，原因尚不清楚，且初级和二级预防数据仍然缺乏。目前没有最佳的常规风险筛查工具可用于准确检测早期和亚临床疾病；PLWHIV 预防性使用他汀类药物和阿司匹林等药物以及抗高血压药物的治疗不足；目前还没有任何方案能显著提高戒烟率、增加体育活动和优化饮食，且最近的报告呼吁加强对 HIV 阳性女性这一特别脆弱亚组的关注。
需要进一步研究以探讨 PLWHIV 中 CVD 风险因素管理的障碍，并加强对 HIV 阳性女性 CVD 预防的关注。
