Tsai Fuu-Jen, Cheng Chi-Fung, Lai Chih-Ho, Wu Yang-Chang, Ho Mao-Wang, Wang Jen-Hsien, Tien Ni, Liu Xiang, Tsang Hsinyi, Lin Ting-Hsu, Liao Chiu-Chu, Huang Shao-Mei, Li Ju-Pi, Lin Jung-Chun, Lin Chih-Chien, Chen Jin-Hua, Liang Wen-Miin, Lin Ying-Ju
School of Chinese Medicine, China Medical University, Taichung, Taiwan.
Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
Oncotarget. 2017 Nov 15;8(63):106369-106381. doi: 10.18632/oncotarget.22465. eCollection 2017 Dec 5.
HIV-infected patients exposed to antiretroviral therapy (ART) have an increased risk for hyperlipidemia and cardiovascular disease. We performed a longitudinal, comprehensive, and population-based study to investigate the cumulative effect of different types of ART regimens on hyperlipidemia risk in the Taiwanese HIV/ART cohort. A total of 13,370 HIV-infected patients (2,674 hyperlipidemia and 10,696 non-hyperlipidemia patients) were recruited after matching for age, gender, and the first diagnosis date of HIV infection by using the National Health Insurance Research Database in Taiwan. Hyperlipidemia risk associated with cumulative ART use, ART adherence, and their combination was assessed. The matched hyperlipidemia group had a larger number of patients using ART and a higher incidence of comorbidities, specifically, respiratory disease and diabetes. Patients with high ART dosage and dose-dependent manner adherence, respectively, demonstrated an increased risk of hyperlipidemia. For single ART regimens, patients receiving nucleoside reverse-transcriptase inhibitors (NRTI/NRTI)- containing regimen had the highest hyperlipidemia risk, followed by protease inhibitor (PI)- containing and non-NRTI- containing regimens. For combination ART regimens, patients receiving a NRTI/NRTI + PI regimen had the highest hyperlipidemia risk. An increased cumulative drug dose was observed in patients who received the PI, NRTI/NRTI, NRTI, and NNRTI regimens in the hyperlipidemia group, when compared to the non-hyperlipidemia group. In conclusion, ART cumulative use, adherence, and regimen may affect hyperlipidemia risk among HIV-infected patients in a dose-dependent manner.
接受抗逆转录病毒疗法（ART）的HIV感染患者患高脂血症和心血管疾病的风险增加。我们进行了一项纵向、全面且基于人群的研究，以调查不同类型ART方案对台湾HIV/ART队列中高脂血症风险的累积影响。利用台湾国民健康保险研究数据库，在根据年龄、性别和HIV感染首次诊断日期进行匹配后，共招募了13370名HIV感染患者（2674名高脂血症患者和10696名非高脂血症患者）。评估了与ART累积使用、ART依从性及其组合相关的高脂血症风险。匹配的高脂血症组使用ART的患者数量更多，合并症发生率更高，具体为呼吸系统疾病和糖尿病。分别具有高ART剂量和剂量依赖性依从性的患者表现出高脂血症风险增加。对于单一ART方案，接受含核苷类逆转录酶抑制剂（NRTI/NRTI）方案的患者高脂血症风险最高，其次是含蛋白酶抑制剂（PI）方案和不含NRTI方案。对于联合ART方案，接受NRTI/NRTI + PI方案的患者高脂血症风险最高。与非高脂血症组相比，高脂血症组中接受PI、NRTI/NRTI、NRTI和非核苷类逆转录酶抑制剂（NNRTI）方案的患者累积药物剂量增加。总之，ART的累积使用、依从性和方案可能以剂量依赖性方式影响HIV感染患者的高脂血症风险。
