阿巴卡韦抗逆转录病毒治疗与 HIV 感染者亚临床血管疾病指标
Abacavir antiretroviral therapy and indices of subclinical vascular disease in persons with HIV.
机构信息
Division of Cardiology, University of Miami Miller School of Medicine, Miami, Florida, United States of America.
Division of Cardiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America.
出版信息
PLoS One. 2022 Mar 10;17(3):e0264445. doi: 10.1371/journal.pone.0264445. eCollection 2022.
OBJECTIVE
Indices of cardiovascular disease (CVD) risk, vascular endothelial dilation, arterial stiffness and endothelial repair were examined in persons with HIV (PWH) on an antiretroviral therapy (ART) that included abacavir (ABC+) in comparison with PWH on ART without abacavir (ABC-), and with HIV seronegative (HIV-) individuals.
APPROACH
The 115 participants (63% men), aged 30-50 years, did not have CVD, metabolic, endocrine, or chronic renal conditions. PWH were on stable ART for six-months or more. Vascular assessments included flow-mediated dilation (FMD), aortic, radial and femoral arterial stiffness (cAIx, crPWV, cfPWV), and thigh and calf arterial compliance (Vmax50). Endothelial repair was indexed by endothelial progenitor cell colony forming units (EPC-CFU). Traditional CVD risk measures included blood pressure, central adiposity, lipids, insulin resistance (HOMA-IR), CRP and ASCVD score. Analyses controlled for demographics (age, sex, education), medications (antihypertensive, statin/fibrate, antipsychotic), and substance abuse (ASSIST).
RESULTS
No group differences were observed in central adiposity, HOMA-IR, CRP, or ASCVD risk score. However, the ABC- group displayed greater dyslipidemia. The ABC+ group displayed no difference on FMD, cAIx, cfPWV or calf Vmax50 compared with other groups. When CD4 count and viral load were controlled, no additional differences between the ABC+ and ABC- groups emerged. Analyses of crPWV and thigh Vmax50 suggested supported by a trend toward lower EPC-CFU in the HIV+ groups than the HIV- group.
CONCLUSIONS
Findings indicate that ABC treatment of 30-50 year-old PWH on stable ART is not likely to contribute in a robust way to higher CVD risk.
目的
在接受包含阿巴卡韦（ABC+）的抗逆转录病毒疗法（ART）的 HIV 感染者（PWH）与未接受阿巴卡韦（ABC-）的 PWH 以及 HIV 阴性（HIV-）个体中，检查心血管疾病（CVD）风险指数、血管内皮扩张、动脉僵硬和内皮修复。
方法
115 名参与者（63%为男性）年龄在 30-50 岁之间，没有 CVD、代谢、内分泌或慢性肾脏疾病。PWH 接受稳定的 ART 治疗已超过六个月。血管评估包括血流介导的扩张（FMD）、主动脉、桡动脉和股动脉僵硬（cAIx、crPWV、cfPWV）以及大腿和小腿动脉顺应性（Vmax50）。内皮修复指数为内皮祖细胞集落形成单位（EPC-CFU）。传统的 CVD 风险指标包括血压、中心性肥胖、血脂、胰岛素抵抗（HOMA-IR）、CRP 和 ASCVD 评分。分析控制了人口统计学因素（年龄、性别、教育程度）、药物（抗高血压药、他汀类药物/贝特类药物、抗精神病药）和物质滥用（ASSIST）。
结果
在中心性肥胖、HOMA-IR、CRP 或 ASCVD 风险评分方面，各组之间没有差异。然而，ABC-组显示出更大的血脂异常。与其他组相比，ABC+组在 FMD、cAIx、cfPWV 或小腿 Vmax50 方面没有差异。当控制 CD4 计数和病毒载量时，ABC+和 ABC-组之间没有出现其他差异。crPWV 和大腿 Vmax50 的分析表明，HIV+组的 EPC-CFU 低于 HIV-组，但这一结果存在趋势。
结论
研究结果表明，在接受稳定 ART 治疗的 30-50 岁 PWH 中，使用 ABC 治疗不太可能显著增加 CVD 风险。
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