Center of Infection Control, National Taiwan University Hospital, Taipei, Taiwan.
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
J Microbiol Immunol Infect. 2019 Aug;52(4):549-555. doi: 10.1016/j.jmii.2019.03.006. Epub 2019 Apr 11.
Cardiovascular disease (CVD) is an emerging cause of morbidity and mortality among HIV-positive patients receiving successful combination antiretroviral therapy, but their CVD risk has been rarely investigated in Asia-Pacific region. We aimed to assess the CVD risk of HIV-positive Taiwanese outpatients.
We did cross-sectional questionnaire interviews to collect information of HIV-positive Taiwanese patients aged 40-79 at the HIV clinics of a medical center from 1 March to 31 August, 2017. The Framingham Risk Score (FRS), Atherosclerotic Cardiovascular Disease (ASCVD) risk score and Data-Collection on Adverse effects of Anti-HIV Drugs (D:A:D) risk score were used to estimate their CVD risk.
Of the screened 1251 patients, 1006 (80.4%) with complete data to assess their CVD risk were included for analyses. The prevalence of patients aged 40-75 and with a high CVD risk was 30.6% by FRS, 3.7% by D:A:D (R) risk score, and 22.2% by ASCVD risk score. In multiple logistic regression, older age, current smoking, higher systolic blood pressure, and higher triglyceride and fasting glucose levels were independently associated with the ASCVD risk score ≥7.5%. If current smokers aged 55-59 had stopped smoking, the proportions of them with a 10-year CVD risk of ≥10% by FRS and ≥7.5% by ASCVD risk score would have decreased by 35.3% and 20.0%, respectively.
Higher CVD risk estimates among HIV-positive Taiwanese aged 40-75 were associated with an older age, current smoking, higher systolic blood pressure, hypertriglyceridemia, and hyperglycemia. Smoking cessation could potentially lead to significant decreases of CVD risk.
心血管疾病（CVD）是接受成功联合抗逆转录病毒治疗的 HIV 阳性患者发病率和死亡率上升的一个新兴原因，但在亚太地区，HIV 阳性患者的 CVD 风险很少被研究。我们旨在评估台湾 HIV 阳性门诊患者的 CVD 风险。
我们在 2017 年 3 月 1 日至 8 月 31 日期间，对一家医疗中心的 HIV 门诊的年龄在 40-79 岁的 1251 名 HIV 阳性台湾患者进行了横断面问卷调查访谈，以收集信息。我们使用 Framingham 风险评分（FRS）、动脉粥样硬化性心血管疾病（ASCVD）风险评分和 Data-Collection on Adverse effects of Anti-HIV Drugs（D:A:D）风险评分来评估他们的 CVD 风险。
在筛选出的 1251 名患者中，有 1006 名（80.4%）患者提供了完整的数据来评估他们的 CVD 风险，这些患者被纳入分析。根据 FRS，40-75 岁且 CVD 风险高的患者比例为 30.6%，根据 D:A:D（R）风险评分的比例为 3.7%，根据 ASCVD 风险评分的比例为 22.2%。在多因素 logistic 回归分析中，年龄较大、当前吸烟、较高的收缩压以及较高的甘油三酯和空腹血糖水平与 ASCVD 风险评分≥7.5%独立相关。如果 55-59 岁的当前吸烟者戒烟，他们的 FRS 10 年 CVD 风险≥10%和 ASCVD 风险评分≥7.5%的比例将分别降低 35.3%和 20.0%。
年龄较大、当前吸烟、较高的收缩压、高甘油三酯血症和高血糖与台湾 40-75 岁 HIV 阳性患者较高的 CVD 风险估计值相关。戒烟可能会显著降低 CVD 风险。
