Gnoni Martin, Beas Renato, Raghuram Anupama, Díaz-Pardavé Celeste, Riva-Moscoso Adrian, Príncipe-Meneses Fortunato S, Vásquez-Garagatti Raúl
Department of Internal Medicine, Good Samaritan Hospital, Cincinnati, OH 45220, United States.
Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, United States.
World J Exp Med. 2021 Nov 20;11(5):66-78. doi: 10.5493/wjem.v11.i5.66.
Cardiovascular disease (CVD) has become one of the commonest causes of comorbidity and mortality among People living with human immunodeficiency virus (HIV) (PLWH) on antiretroviral therapy (ART). Nearly 50% of PLWH are likely to have an increased risk of developing CVD, including coronary heart disease, cerebrovascular disease, peripheral artery disease and aortic atherosclerosis. Aside from the common risk factors, HIV infection itself and side effects of antiretroviral therapy contribute to the pathophysiology of this entity. Potential non-pharmacological therapies are currently being tested worldwide for this purpose, including eating patterns such as Intermittent fasting (IF). IF is a widespread practice gaining high level of interest in the scientific community due to its potential benefits such as improvement in serum lipids and lipoproteins, blood pressure (BP), platelet-derived growth factor AB, systemic inflammation, and carotid artery intima-media thickness among others cardiovascular benefits. This review will focus on exploring the potential role of intermittent fasting as a non-pharmacological and cost-effective strategy in decreasing the burden of cardiovascular diseases among HIV patients on ART due to its intrinsic properties improving the main cardiovascular risk factors and modulating inflammatory pathways related to endothelial dysfunction, lipid peroxidation and aging. Intermittent fasting regimens need to be tested in clinical trials as an important, cost-effective, and revolutionary coadjutant of ART in the fight against the increased prevalence of cardiovascular disease in PLWH.
心血管疾病(CVD)已成为接受抗逆转录病毒疗法(ART)的人类免疫缺陷病毒(HIV)感染者(PLWH)中最常见的合并症和死亡原因之一。近50%的PLWH可能有患CVD的风险增加,包括冠心病、脑血管疾病、外周动脉疾病和主动脉粥样硬化。除了常见的风险因素外,HIV感染本身和抗逆转录病毒疗法的副作用也促成了这一疾病的病理生理过程。目前,包括间歇性禁食(IF)等饮食模式在内的潜在非药物疗法正在全球范围内进行测试。IF是一种广泛应用的做法,因其潜在益处,如改善血清脂质和脂蛋白、血压(BP)、血小板衍生生长因子AB、全身炎症以及颈动脉内膜中层厚度等心血管益处,而在科学界引起了高度关注。本综述将重点探讨间歇性禁食作为一种非药物且具有成本效益的策略在减轻接受ART的HIV患者心血管疾病负担方面的潜在作用,因为其内在特性可改善主要心血管危险因素并调节与内皮功能障碍、脂质过氧化和衰老相关的炎症途径。间歇性禁食方案需要在临床试验中进行测试,作为ART在对抗PLWH中心血管疾病患病率上升斗争中的一种重要、具有成本效益且具有革命性的辅助手段。