University of Alberta, Edmonton, Alberta, Canada.
Unité d'immunopathologie virale, Centre de recherche du CHU Sainte-Justine, Montréal, Québec, Canada.
J Acquir Immune Defic Syndr. 2019 Apr 15;80(5):590-595. doi: 10.1097/QAI.0000000000001955.
Systemic inflammation, platelet dysfunction, and endothelial activation persist in people living with HIV despite sustained virologic suppression (SVS) with combined antiretroviral therapy (cART) and may lead to complications such as atherosclerosis and cardiovascular disease. Angiopoietin-1 (Ang-1) is a key regulator of angiogenesis and endothelial activation and has been studied as an objective biomarker in disease states such as atherosclerosis, sepsis, and severe malaria.
Eight pediatric HIV care centers across Canada.
Cross-sectional study of 61 children living with vertically acquired HIV on cART with undetectable RNA viral load. Plasma levels of Ang-1 were measured by ELISA and analyzed in relation to clinical characteristics abstracted from medical records.
Ang-1 levels were directly correlated with clinical indices of virologic control: cumulative proportion of life on effective cART (ρ = +0.35, P = 0.0078) and cumulative proportion of life with SVS (ρ = +0.36, P = 0.0049). Furthermore, higher Ang-1 levels were associated with younger age at SVS (ρ = -0.56, P < 0.0001). These associations remained statistically significant in multivariable linear regression models adjusting for potential confounders (P < 0.05 for all associations).
Early effective cART and SVS were associated with higher Ang-1 levels in children living with vertically acquired HIV-1.
尽管联合抗逆转录病毒疗法（cART）可实现持续病毒学抑制（SVS），但仍有艾滋病毒感染者存在全身炎症、血小板功能障碍和内皮细胞激活，这可能导致动脉粥样硬化和心血管疾病等并发症。血管生成素-1（Ang-1）是血管生成和内皮细胞激活的关键调节因子，已在动脉粥样硬化、败血症和重症疟疾等疾病状态下作为客观生物标志物进行了研究。
加拿大 8 家儿科艾滋病毒护理中心。
对接受 cART 治疗且 RNA 病毒载量不可检测的 61 名垂直获得性艾滋病毒感染儿童进行横断面研究。通过 ELISA 测量血浆 Ang-1 水平，并结合从病历中提取的临床特征进行分析。
Ang-1 水平与病毒学控制的临床指标直接相关：有效 cART 的累计生活比例（ρ=+0.35，P=0.0078）和 SVS 的累计生活比例（ρ=+0.36，P=0.0049）。此外，较高的 Ang-1 水平与 SVS 时的年龄较小有关（ρ=-0.56，P<0.0001）。在调整潜在混杂因素的多变量线性回归模型中，这些关联仍然具有统计学意义（所有关联的 P<0.05）。
在接受垂直获得性 HIV-1 的儿童中，早期有效的 cART 和 SVS 与较高的 Ang-1 水平相关。
