随着时间的推移，艾滋病毒感染者动脉粥样硬化性心血管疾病风险的变化。

Changes in atherosclerotic cardiovascular disease risk over time among people living with HIV.

机构信息

Kirby Institute, UNSW Sydney, Sydney, Australia.

Department of Tropical and Infectious Diseases, Udayana University, Denpasar, Indonesia.

出版信息

J Antimicrob Chemother. 2024 Apr 2;79(4):897-902. doi: 10.1093/jac/dkae049.

DOI:10.1093/jac/dkae049

PMID:38416697

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10984948/

Abstract

OBJECTIVE

To describe changes in atherosclerotic cardiovascular disease (ASCVD) risk over time among people living with HIV (PLHIV).

METHODS

We used data from the TREAT Asia HIV Observational Database (TAHOD) and the Australian HIV Observational Database (AHOD). Five-year ASCVD risk was calculated using the D:A:D equation. Individuals were eligible for inclusion if they were aged ≥18 years, had started ART, had no previous history of ASCVD and had complete ASCVD risk factor data available within the first 5 years of ART initiation.

RESULTS

A total of 3368 adults contributed data, 3221 were from TAHOD and 147 were from AHOD. The median age at ART initiation was 36 [IQR 31-43] years for TAHOD participants, and 42 [IQR 35-50] years for AHOD participants. Most TAHOD (70.4%) and AHOD (91.8%) participants were male. Overall, ASCVD risk increased from 0.84% (95% CI 0.81%-0.87%) at ART initiation to 1.34% (95% CI 1.29%-1.39%) after 5 years on ART. After adjusting for traditional and HIV-associated ASCVD risk factors, ASCVD risk increased at a similar rate among sub-populations defined by HIV exposure (heterosexuals, men who have sex with men, people who inject drugs), race/ethnicity (Caucasian and Asian) and nadir CD4 at ART initiation (<200 and ≥200 cells/mm3).

CONCLUSIONS

These findings emphasize the growing burden of ASCVD risk among PLHIV and the need to develop interventions that are effective across a broad range of HIV sub-populations.

摘要

目的

描述艾滋病毒感染者（PLHIV）的动脉粥样硬化性心血管疾病（ASCVD）风险随时间的变化。

方法

我们使用了 TREAT Asia HIV 观察数据库（TAHOD）和澳大利亚 HIV 观察数据库（AHOD）的数据。使用 D:A:D 方程计算 5 年 ASCVD 风险。符合条件的纳入标准为年龄≥18 岁、开始接受抗逆转录病毒治疗（ART）、无 ASCVD 既往史且在 ART 开始后 5 年内可获得完整的 ASCVD 风险因素数据。

结果

共有 3368 名成年人提供了数据，其中 3221 名来自 TAHOD，147 名来自 AHOD。ART 开始时 TAHOD 参与者的中位年龄为 36[IQR 31-43]岁，AHOD 参与者的中位年龄为 42[IQR 35-50]岁。大多数 TAHOD（70.4%）和 AHOD（91.8%）参与者为男性。总体而言，ASCVD 风险从 ART 开始时的 0.84%（95%CI 0.81%-0.87%）增加到 5 年后的 1.34%（95%CI 1.29%-1.39%）。在调整了传统和与 HIV 相关的 ASCVD 风险因素后，在不同的 HIV 暴露人群（异性恋、男男性接触者、静脉吸毒者）、种族/民族（白人和亚洲人）和 ART 开始时的最低 CD4 细胞计数（<200 和≥200 个细胞/mm3）亚组中，ASCVD 风险以相似的速度增加。