Kobe Elizabeth A, Thakkar Aarti, Matai Sarina, Akkaya Esra, Pagidipati Neha J, McGarrah Robert W, Bloomfield Gerald S, Shah Nishant P
Duke University Hospitals, 2301 Erwin Road, Suite 7400, Cubicle 13, Durham, NC 27710, USA.
Raleigh Charter High School, 1307 Glenwood Ave, Raleigh, NC 27605, USA.
Am J Prev Cardiol. 2024 Oct 28;20:100888. doi: 10.1016/j.ajpc.2024.100888. eCollection 2024 Dec.
Effective antiretroviral therapy (ART) is now nearly ubiquitous. However, the survival benefits conferred with ART contribute to an aging human immunodeficiency virus (HIV) population and increased risk of chronic diseases, like atherosclerotic cardiovascular disease (ASCVD). Furthermore, HIV is a known risk enhancer of ASCVD and acknowledged as such in the current 2018 AHA/ACC Blood Cholesterol guidelines [1]. This makes cardiovascular risk factor identification and modification among people living with HIV (PLWH) of increasing importance to prevent cardiovascular events. In this review, we aim to summarize the epidemiology and pathogenesis of how HIV is linked to atherogenesis and to discuss cardiometabolic risk factor modification specific to PLWH, covering obesity, hypertension, insulin resistance, metabolic dysfunction-associated steatotic liver disease, and dyslipidemia.
有效的抗逆转录病毒疗法（ART）如今几乎无处不在。然而，ART带来的生存益处促使感染人类免疫缺陷病毒（HIV）的人群老龄化，并增加了患慢性疾病的风险，如动脉粥样硬化性心血管疾病（ASCVD）。此外，HIV是ASCVD的已知风险增强因素，在当前2018年美国心脏协会/美国心脏病学会血液胆固醇指南中也得到了认可[1]。这使得识别和改善HIV感染者（PLWH）的心血管危险因素对于预防心血管事件变得越来越重要。在这篇综述中，我们旨在总结HIV与动脉粥样硬化发生之间的流行病学和发病机制，并讨论PLWH特有的心脏代谢危险因素改善措施，包括肥胖、高血压、胰岛素抵抗、代谢功能障碍相关脂肪性肝病和血脂异常。
