抗逆转录病毒疗法对初治 HIV 患者动脉僵硬度、代谢特征、血管和全身炎症细胞因子的影响：一项为期一年的前瞻性研究。
Effect of antiretroviral therapy on decreasing arterial stiffness, metabolic profile, vascular and systemic inflammatory cytokines in treatment-naïve HIV: A one-year prospective study.
机构信息
HIV Unit Department, University Hospital "Fray Antonio Alcalde", University of Guadalajara, Guadalajara, Mexico.
Department of Physiology, Arterial Stiffness Laboratory, University of Guadalajara, Guadalajara, Mexico.
出版信息
PLoS One. 2023 Mar 17;18(3):e0282728. doi: 10.1371/journal.pone.0282728. eCollection 2023.
INTRODUCTION
Cardiovascular disease is a major cause of death among people living with HIV (PLH). Non-treated PLH show increased levels of inflammation and biomarkers of vascular activation, and arterial stiffness as a prognostic cardiovascular disease risk factor. We investigated the effect of one year of ART on treatment-naïve HIV(+) individuals on arterial stiffness and inflammatory and vascular cytokines.
METHODS
We cross-sectionally compared aortic stiffness via tonometry, inflammatory, and vascular serum cytokines on treatment-naïve (n = 20) and HIV (-) (n = 9) matched by age, sex, metabolic profile, and Framingham score. We subsequently followed young, treatment-naïve individuals after 1-year of ART and compared aortic stiffness, metabolic profile, and inflammatory and vascular serum biomarkers to baseline. Inflammatory biomarkers included: hs-CRP, D-Dimer, SAA, sCD163s, MCP-1, IL-8, IL-18, MRP8/14. Vascular cytokines included: myoglobin, NGAL, MPO, Cystatin C, ICAM-1, VCAM-1, and MMP9.
RESULTS
Treatment-naïve individuals were 34.8 years old, mostly males (95%), and with high smoking prevalence (70%). Baseline T CD4+ was 512±324 cells/mcL. cfPWV was similar between HIV(-) and treatment-naïve (6.8 vs 7.3 m/s; p = 0.16) but significantly decreased after ART (-0.52 m/s; 95% CI -0.87 to -0.16; p0.006). Almost all the determined cytokines were significantly higher compared to controls, except for MCP-1, myoglobin, NGAL, cystatin C, and MMP-9. At follow-up, only total cholesterol and triglycerides increased and all inflammatory cytokines significantly decreased. Regarding vascular cytokines, MPO, ICAM-1, and VCAM-1 showed a reduction. D-Dimer tended to decrease (p = 0.06) and hs-CRP did not show a significant reduction (p = 0.17).
CONCLUSION
One year of ART had a positive effect on reducing inflammatory and vascular cytokines and arterial stiffness.
简介
心血管疾病是导致艾滋病毒感染者（PLHIV）死亡的主要原因。未经治疗的 PLHIV 表现出炎症和血管激活生物标志物水平升高，以及动脉僵硬度作为心血管疾病预后危险因素。我们研究了接受抗逆转录病毒治疗（ART）一年对未经治疗的 HIV（+）个体的动脉僵硬度以及炎症和血管细胞因子的影响。
方法
我们通过张力测量法比较了未经治疗的（n = 20）和 HIV（-）（n = 9）个体的动脉僵硬度，这些个体按年龄、性别、代谢特征和弗雷明汉评分进行匹配。随后，我们对未经治疗的年轻个体进行了 1 年的 ART 随访，并将其与基线时的动脉僵硬度、代谢特征以及炎症和血管血清生物标志物进行了比较。炎症生物标志物包括：hs-CRP、D-二聚体、SAA、sCD163s、MCP-1、IL-8、IL-18、MRP8/14。血管细胞因子包括：肌红蛋白、NGAL、MPO、胱抑素 C、ICAM-1、VCAM-1 和 MMP9。
结果
未经治疗的个体年龄为 34.8 岁，大多数为男性（95%），且吸烟率较高（70%）。基线时 T 细胞 CD4+为 512±324 个/μL。cfPWV 在 HIV（-）和未经治疗的个体之间相似（6.8 与 7.3 m/s；p = 0.16），但在 ART 后显著降低（-0.52 m/s；95%CI -0.87 至 -0.16；p0.006）。与对照组相比，几乎所有确定的细胞因子均显著升高，除 MCP-1、肌红蛋白、NGAL、胱抑素 C 和 MMP-9 外。在随访时，仅总胆固醇和甘油三酯增加，所有炎症细胞因子显著降低。关于血管细胞因子，MPO、ICAM-1 和 VCAM-1 减少。D-二聚体呈下降趋势（p = 0.06），hs-CRP 无显著下降（p = 0.17）。
结论
接受抗逆转录病毒治疗一年对降低炎症和血管细胞因子以及动脉僵硬度有积极影响。
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