Muller Luize, Sewchuran Tanusha, Durand Miranda
Department of Radiology, Faculty of Health Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
South Afr J HIV Med. 2021 May 13;22(1):1241. doi: 10.4102/sajhivmed.v22i1.1241. eCollection 2021.
International literature reported an increased prevalence of cardiovascular disease in persons living with HIV (PLWH), inferring an association with accelerated coronary atherosclerosis and plaque formation. Few local studies of HIV-related cardiac disease have confirmed this. Early identification of cardiac plaques would assist clinicians with risk stratification and implementation of treatment strategies to reduce morbidity and mortality. In resource-limited settings the use of conventional computed tomography (CT) may have a role in identifying at-risk individuals.
This hypothesis-generating study was aimed at determining the contribution of HIV to accelerated vascular aging by assessing cardiac calcifications, incidentally detected on conventional CT chest imaging, in a young HIV-positive population.
A retrospective quantitative analysis was performed at a tertiary hospital in KwaZulu-Natal, South Africa, over a 5-year period. Young patients (18-45 years) who underwent CT chest imaging for varied indications were included, further sub-categorised by immune status, the presence, absence and location of calcifications. Patients with unknown HIV statuses were excluded.
An increased probability of cardiac calcification with increasing age, independent of the HIV status, was established. No statistically significant difference could be demonstrated between the cohorts. In the pre-contrasted subcategory, a lower -value suggested an 'imminent' statistical significance. Contrast may have obscured some calcifications. The failure to record the immune status in a large number of patients resulted in their exclusion and limited the study.
The increased prevalence of incidentally detected cardiac calcifications in young HIV-infected individuals warrants further evaluation and cardiovascular risk stratification.
国际文献报道，人类免疫缺陷病毒（HIV）感染者（PLWH）心血管疾病的患病率有所上升，这意味着与冠状动脉粥样硬化加速和斑块形成有关。很少有关于HIV相关心脏病的本地研究证实这一点。早期识别心脏斑块将有助于临床医生进行风险分层并实施治疗策略，以降低发病率和死亡率。在资源有限的环境中，使用传统计算机断层扫描（CT）可能有助于识别高危个体。
这项产生假设的研究旨在通过评估在常规胸部CT成像中偶然发现的心脏钙化，确定HIV对年轻HIV阳性人群血管老化加速的影响。
在南非夸祖鲁-纳塔尔省的一家三级医院进行了为期5年的回顾性定量分析。纳入因各种适应症接受胸部CT成像的年轻患者（18-45岁），并根据免疫状态、钙化的存在、缺失和位置进一步分类。排除HIV状态未知的患者。
确定了心脏钙化概率随年龄增加而增加，与HIV状态无关。各队列之间未显示出统计学上的显著差异。在非增强亚组中，较低的值表明有“即将出现”的统计学意义。造影剂可能掩盖了一些钙化。大量患者未记录免疫状态导致他们被排除在外，限制了研究。
在年轻HIV感染者中偶然发现的心脏钙化患病率增加，值得进一步评估和进行心血管风险分层。
