UCL Institute for Global Health, Mortimer Market Centre, Off Capper Street, London, WC1E 6JB, UK.
UCL Institute for Global Health, Mortimer Market Centre, Off Capper Street, London, WC1E 6JB, UK; National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Blood Borne and Sexually Transmitted Infections at University College London, UK(1).
Maturitas. 2018 Feb;108:58-70. doi: 10.1016/j.maturitas.2017.11.012. Epub 2017 Nov 14.
Advances in the treatment of HIV have led to increasing numbers of people living with HIV reaching older age. Age-related comorbid conditions, such as cardiovascular disease (CVD), are therefore of increasing importance in HIV clinical practice. Over half the global population of people living with HIV are female. We present a narrative literature review of 39 studies exploring CVD in women living with HIV (WLHIV), with particular reference to coronary heart disease, and focusing on: (1) epidemiology, (2) pathophysiology, (3) risk factors (including traditional risk factors and HIV-related risk factors), and (4) management. Although we found significant gaps in the literature on CVD in WLHIV, data suggest that: HIV increases the risk of CVD in women even more than it does in men; certain cardiometabolic risk factors (such as obesity and metabolic syndrome) are more prevalent in WLHIV than their male counterparts; and risk factors such as hyperlipidaemia and hypertension are not optimally managed in this population. Clinicians working with WLHIV therefore need to be aware that this is a patient group at elevated cardiovascular risk, and should be familiar with relevant guidelines.
HIV 治疗的进展使得越来越多的 HIV 感染者达到老年。因此，与年龄相关的合并症，如心血管疾病（CVD），在 HIV 临床实践中变得越来越重要。全球超过一半的 HIV 感染者为女性。我们对 39 项研究进行了叙述性文献综述，这些研究探讨了 HIV 女性感染者（WLHIV）的 CVD，特别关注冠心病，并侧重于：（1）流行病学，（2）病理生理学，（3）危险因素（包括传统危险因素和 HIV 相关危险因素），以及（4）管理。尽管我们发现了关于 WLHIV 心血管疾病文献中的重大空白，但数据表明：HIV 使女性患 CVD 的风险比男性更高；某些心血管代谢危险因素（如肥胖和代谢综合征）在 WLHIV 中比男性更为普遍；并且该人群中某些危险因素（如高脂血症和高血压）的管理并不理想。因此，与 WLHIV 合作的临床医生需要意识到这是一个心血管风险增加的患者群体，并且应该熟悉相关指南。
