From the Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Institut de Recerca del Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
IISPV, Universitat Rovira I Virgili, Tarragona, Spain.
Expert Opin Pharmacother. 2021 Apr;22(6):743-753. doi: 10.1080/14656566.2020.1856075. Epub 2021 Jan 4.
Cardiovascular disease (CVD) continues to be an essential cause of morbidity and mortality among people living with human immunodeficiency virus infection (PLWH). Since the bulk of cardiovascular risk (CVR) factors are shared between PLWH and the general population, prevention and treatment strategies are similar. However, there are CVR factors particular to PLWH, which need separate consideration. These factors are those HIV-dependent, those related to HIV-derived consequences, and combination antiretroviral therapy (cART)-dependent.: In this review, the authors discuss the management of CVD in PLWH, with a special interest in pharmacological treatment and drug-drug interactions with cART.: In recent years, we have witnessed a decreased CVD morbidity and mortality in PLWH, which probably reflects an improvement in the management of CVR factors and CVD in these patients, partially thanks to new developments in antiretroviral therapy. Therefore, although there is still room for improvement, at present, the old desideratum of equaling PLWH and the general population in terms of CVD incidence and prognosis is a little closer.
心血管疾病(CVD)仍然是导致人类免疫缺陷病毒感染患者(PLWH)发病率和死亡率的重要原因。由于大部分心血管风险(CVR)因素在 PLWH 和普通人群中是共同存在的,因此预防和治疗策略是相似的。但是,PLWH 也有一些特定的 CVR 因素需要单独考虑。这些因素包括 HIV 依赖性因素、与 HIV 相关后果相关的因素以及联合抗逆转录病毒疗法(cART)依赖性因素。在本文中,作者讨论了 PLWH 中 CVD 的管理,特别关注药物治疗和与 cART 的药物相互作用。近年来,我们观察到 PLWH 的 CVD 发病率和死亡率下降,这可能反映出对这些患者的 CVR 因素和 CVD 的管理得到了改善,部分归功于抗逆转录病毒治疗的新进展。因此,尽管仍有改进的空间,但目前,PLWH 在 CVD 发病率和预后方面与普通人群相平等的旧愿望已经更加接近了。