Hileman Corrilynn O, McComsey Grace A
1 Division of Infectious Diseases, Department of Medicine, MetroHealth Medical Center , Cleveland, Ohio.
2 Case Western Reserve University , Cleveland, Ohio.
AIDS Res Hum Retroviruses. 2018 Mar;34(3):282-285. doi: 10.1089/AID.2017.0164. Epub 2017 Nov 17.
Smoking is an important contributor to cardiovascular disease risk and is highly prevalent in the HIV population. In the Stopping Atherosclerosis and Treating Unhealthy Bone with Rosuvastatin in HIV trial (SATURN-HIV), a 96-week, randomized placebo-controlled study testing the effect of rosuvastatin on subclinical vascular disease and immune activation in HIV-infected adults, rosuvastatin improved immune activation and arrested common carotid artery intima media thickness (CCA IMT) progression. In this exploratory analysis, ANOVA was used to test for effect modification by smoking. One-hundred forty-seven adults were included (72 in rosuvastatin group; 75 in placebo group). Groups were similar at baseline. Overall, mean ± SD age was 45.4 ± 9.9 years, 115 (78%) were men and 100 (68%) were African American. Ninety-three (63%) were current smokers (mean ± SD 0.6 ± 0.44 packs/day) and another 24 (16%) were smokers in the past. There were statistically significant randomization group by smoking status interactions for 0-24 (p = .01) and 0-48 (p < .01) week changes in proportion of activated CD4 T cells and for 0-48 (p < .01) and 0-96 (trend only; p = .06) week changes in CCA IMT. No effect modification by smoking was detected for changes in markers of inflammation or monocyte activation. The beneficial effect of rosuvastatin on CCA IMT was not apparent in smokers although T cell activation improved to a greater degree in this subgroup.
吸烟是心血管疾病风险的一个重要促成因素，在艾滋病毒感染者中非常普遍。在“用瑞舒伐他汀阻止动脉粥样硬化并治疗艾滋病毒感染者的不健康骨骼”试验（SATURN - HIV）中，这是一项为期96周的随机安慰剂对照研究，旨在测试瑞舒伐他汀对艾滋病毒感染成年人亚临床血管疾病和免疫激活的影响，结果显示瑞舒伐他汀改善了免疫激活并阻止了颈总动脉内膜中层厚度（CCA IMT）进展。在这项探索性分析中，采用方差分析来检验吸烟对效应的修正作用。共纳入147名成年人（瑞舒伐他汀组72名；安慰剂组75名）。两组在基线时相似。总体而言，平均年龄±标准差为45.4±9.9岁，115名（78%）为男性，100名（68%）为非裔美国人。93名（63%）为当前吸烟者（平均±标准差0.6±0.44包/天），另外24名（16%）为既往吸烟者。在活化CD4 T细胞比例的0 - 24周（p = 0.01）和0 - 48周（p < 0.01）变化以及CCA IMT的0 - 48周（p < 0.01）和0 - 96周（仅趋势；p = 0.06）变化方面，随机分组与吸烟状态之间存在统计学显著的交互作用。在炎症标志物或单核细胞激活变化方面未检测到吸烟对效应的修正作用。尽管在该亚组中T细胞激活改善程度更大，但瑞舒伐他汀对CCA IMT的有益作用在吸烟者中并不明显。
