Hidalgo Jose A, Florez Alberto, Agurto Cecilia, Pinedo Yvett, Ayarza Rosemarie, Rodriguez Lourdes, La Rosa Alberto, Gutierrez Raul
Almenara Hospital, Lima, Peru.
Vía Libre HIV Clinic, Lima, Lima.
Open AIDS J. 2018 Oct 17;12:126-135. doi: 10.2174/1874613601812010126. eCollection 2018.
There is scarcity of data about the prevalence of non-AIDS defining comorbidities among stable HIV-infected patients in Peru.
We aimed to describe the most frequent cardiometabolic comorbidities found among ambulatory adults on ARV in Peru.
A review of records for patients attending regular visits at 5 clinics in Lima-Callao in January-February 2016 is presented. Patients were adults on ARV for >6 months, with no recent AIDS-defining condition.
Three hundred and five medical charts were reviewed. Most patients were male (73.1%, n=223) with a mean age of 46.0 years. Mean time from HIV diagnosis was 9.41 yrs. and mean duration of ARV was 7.78 yrs. Most patients were on an NNRTI-based first line regimen (76.4%, n=233), and 12.1% (n=37) were on rescue regimens. Median CD4 count was 614.2 cells/µL and the proportion of patients with viral load <40 c/mL was 90.8% (n=277). Most frequent metabolic diagnoses were dyslipidemia (51.5%, n=157), obesity (11.1%, n=34), and diabetes mellitus (7.2%, n=22). Hypertension was diagnosed in 8.9% (n=27). Other diagnoses of cardiovascular disease were documented in 3.3% (n=10). Pharmacologic treatment was prescribed in 91.3% of patients with diabetes or hypertension, but in only 29.3% of patients with dyslipidemia.
A high proportion of metabolic comorbidities was found, with dyslipidemia being the most frequent, followed by obesity and diabetes. In contrast, cardiovascular disease was documented less frequently. Medical treatment was started for only a third of dyslipidemia patients. HIV care policies need to consider proper management of chronic comorbidities to optimize long-term outcomes.
关于秘鲁稳定的HIV感染患者中非艾滋病定义合并症的患病率的数据稀缺。
我们旨在描述在秘鲁接受抗逆转录病毒治疗的门诊成年患者中发现的最常见的心脏代谢合并症。
呈现了对2016年1月至2月在利马-卡亚俄的5家诊所定期就诊患者记录的回顾。患者为接受抗逆转录病毒治疗超过6个月的成年人，近期无艾滋病定义疾病。
共审查了305份病历。大多数患者为男性（73.1%，n = 223），平均年龄46.0岁。从HIV诊断到现在的平均时间为9.41年，抗逆转录病毒治疗的平均持续时间为7.78年。大多数患者采用基于非核苷类逆转录酶抑制剂的一线治疗方案（76.4%，n = 233），12.1%（n = 37）采用挽救治疗方案。CD4细胞计数中位数为614.2个/微升，病毒载量<40拷贝/毫升的患者比例为90.8%（n = 277）。最常见的代谢诊断为血脂异常（51.5%，n = 157）、肥胖（11.1%，n = 34）和糖尿病（7.2%，n = 22）。高血压诊断率为8.9%（n = 27）。其他心血管疾病诊断记录为3.3%（n = 10）。91.3%的糖尿病或高血压患者接受了药物治疗，但只有29.3%的血脂异常患者接受了药物治疗。
发现高比例的代谢合并症，血脂异常最为常见，其次是肥胖和糖尿病。相比之下，心血管疾病记录较少。只有三分之一的血脂异常患者开始接受药物治疗。HIV护理政策需要考虑对慢性合并症进行适当管理，以优化长期治疗效果。
