Department of Medicine, Johns Hopkins Division of Cardiology, Baltimore, MD, USA.
Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Curr Cardiol Rep. 2022 Sep;24(9):1149-1157. doi: 10.1007/s11886-022-01741-1. Epub 2022 Jul 8.
Because of effective combination antiretroviral therapy, people living with HIV (PLWH) are living longer but developing chronic age-related conditions including cardiovascular disease (CVD), the leading cause of death globally. This review aims to discuss the epidemiology, mechanisms, and clinical considerations of CVD in PLWH from a global perspective.
PLWH are at greater risk for CVD at chronologically younger ages than those without HIV. Potential underlying mechanisms for CVD in PLWH include systemic inflammation, comorbidities, immune-mediated, or treatment-related mechanisms. There is also risk factor variation based on geographical location, including non-traditional CVD risk factors. CVD is prevalent in PLWH and increasing on a global scale. Further understanding the unique epidemiology, risk factors, and treatment of CVD in this population will improve the care of PLWH.
由于有效的联合抗逆转录病毒疗法,艾滋病毒感染者(PLWH)的寿命延长,但也出现了与年龄相关的慢性疾病,包括心血管疾病(CVD),这是全球范围内的主要死亡原因。本综述旨在从全球角度讨论 PLWH 中 CVD 的流行病学、发病机制和临床注意事项。
与未感染 HIV 的人相比,PLWH 发生 CVD 的年龄更小。PLWH 中 CVD 的潜在发病机制包括全身炎症、合并症、免疫介导或治疗相关机制。地理位置也会导致危险因素发生变化,包括非传统 CVD 危险因素。PLWH 中 CVD 的发病率很高,而且在全球范围内呈上升趋势。进一步了解该人群 CVD 的独特流行病学、危险因素和治疗方法将改善 PLWH 的护理。