Ello Frederic N, Soya Esaie K, Kassi N'douba A, Coffie Patrick A, Koaukou Gisèle A, Mossou Melaine C, Adama Doumbia, Coulibaly Icklo, Ehui Eboi, Tanon Aristophane, Eholie Serge P
Département de Dermatologie-Infectiologie, Unité de Formation et de Recherche des Sciences Médicales, Université Felix Houphouët-Boigny, Abidjan, Côte d'Ivoire.
Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire.
S Afr J Infect Dis. 2021 Feb 16;36(1):187. doi: 10.4102/sajid.v36i1.187. eCollection 2021.
With success and effective long-term antiretroviral treatment (ART), HIV-infected patients live longer and frequently developed non-communicable diseases (NCDs). Few studies have been conducted in low-income countries, particularly in West Africa.
We carried out a cross-sectional study in the referral HIV centre of the Service des Maladies Infectieuses et Tropicales (SMIT) in Abidjan. From April to September 2015, we consecutively included HIV-1 infected patients aged 18 years and older, and on ART for a minimum of 12 months. Data were collected using a structured questionnaire, and entered into the centre's computerised HIV database. Clinical assessment, laboratory tests, electrocardiogram, transthoracic echocardiography and vascular Doppler ultrasound were performed. The main outcome was the prevalence of patients with severe cardiovascular abnormalities (SCA). Univariate and multivariate logistic regressions were used to identify factors associated with SCA.
Out of 278 patients (median age 46 years, interquartile range [IQR: 41-52]), 74.5% were female. Overall, the median duration of ART was 84 months (IQR: 54-126). One hundred and ninety-nine (71.6%) patients were on first-line ART regimen and 229 (82.4%) were virologically suppressed with a median CD4 count of 511 cells/mm (IQR: 347-529). Basically, cardiovascular abnormalities were mainly non-obstructive carotid plaques (19.1%) followed with left ventricular diastolic dysfunction (16.5%). The overall prevalence of SCA in the study population was 7.6% (95% Confidence Interval [95% CI]: 4.7-11.3). The prevalence of SCA 7.6% (95% Confidence Interval [95% CI]: 4.7-11.3). In multivariate analysis, age > 50 years and nadir CD4 count > 200 cells/mm were significant predictors of SCA.
The prevalence of SCA is high in West African HIV-treated patients. Given the high mortality associated with cardiovascular diseases in the general population, refining disease preventive strategies in HIV-positive subjects is essential to continue prolonging their life.
随着抗逆转录病毒治疗（ART）的成功与长期有效，感染HIV的患者寿命延长，且常罹患非传染性疾病（NCDs）。在低收入国家，尤其是西非地区，相关研究较少。
我们在阿比让热带传染病服务中心（SMIT）的HIV转诊中心开展了一项横断面研究。2015年4月至9月，我们连续纳入年龄在18岁及以上、接受ART至少12个月的HIV-1感染患者。通过结构化问卷收集数据，并录入该中心的HIV计算机数据库。进行临床评估、实验室检查、心电图、经胸超声心动图和血管多普勒超声检查。主要结局是严重心血管异常（SCA）患者的患病率。采用单因素和多因素逻辑回归分析来确定与SCA相关的因素。
278例患者（中位年龄46岁，四分位间距[IQR：41 - 52]）中，74.5%为女性。总体而言，ART的中位疗程为84个月（IQR：54 - 126）。199例（71.6%）患者采用一线ART方案，229例（82.4%）病毒学抑制，CD4细胞计数中位数为511个/mm³（IQR：347 - 529）。基本上，心血管异常主要为非阻塞性颈动脉斑块（19.1%），其次是左心室舒张功能障碍（16.5%）。研究人群中SCA的总体患病率为7.6%（95%置信区间[95%CI]：4.7 - 11.3）。在多因素分析中，年龄>50岁和CD4细胞计数最低点>200个/mm³是SCA的显著预测因素。
在接受治疗的西非HIV患者中，SCA的患病率较高。鉴于一般人群中心血管疾病相关的高死亡率，完善HIV阳性患者的疾病预防策略对于继续延长其寿命至关重要。
