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近期感染SARS-CoV-2的HIV感染者的大血管功能

Macrovascular Function in People with HIV After Recent SARS-CoV-2 Infection.

作者信息

Salazar Ana S, Vincent Louis, Ebner Bertrand, Nogueira Nicholas Fonseca, Krauss Leah, Meyer Madison S, Grant Jelani, Aguilar Natalie, Pester Mollie S, Parker Meela, Gonzalez Alex, Mendez Armando, Carrico Adam, Hurwitz Barry E, Alcaide Maria L, Martinez Claudia

机构信息

Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA.

Department of Internal Medicine, University of Miami/Jackson Memorial Hospital, Miami, FL 33101, USA.

出版信息

J Vasc Dis. 2025 Mar;4(1). doi: 10.3390/jvd4010004. Epub 2025 Jan 26.

Abstract

BACKGROUND

People with HIV (PWH) are at increased risk of vascular dysfunction and cardiovascular disease (CVD). SARS-CoV-2 infection has been associated with acute CVD complications. The aim of the study was to as-sess macrovascular function as an early indicator of CVD risk in PWH after mild SARS-CoV-2 infection.

METHODS

PWH aged 20-60 years, with undetectable viral load (RNA < 20 copies/mL), on stable antiretroviral therapy (≥6 months) and history of mild COVID-19 (≥30 days) without any CVD manifestations prior to enrollment were recruited. Participants were excluded if they had history of diabetes mellitus, end-stage renal disease, heart or respiratory disease. Participants were matched 1:1 to pre-pandemic PWH. A health survey, surrogate measures of CVD risk, and macrovascular function (brachial artery flow-mediated vasodilation and arterial stiffness assessments via applanation tonometry) were compared between group.

RESULTS

A total of 17 PWH and history of COVID-19 (PWH/COV+) were matched with 17 PWH without COVID-19 (PWH/COV-) pre-pandemic. Mean age (45.5 years), sex (76.5% male), body mass index (27.3), and duration of HIV infection (12.2 years) were not different between groups. Both groups had comparable CVD risk factors (total cholesterol, LDL, HDL, systolic and diastolic blood pressure). There were no differences in measures of flow mediated arterial dilatation or arterial stiffness after 30 days of SARS-CoV-2 infection.

CONCLUSIONS

After recent SARS-CoV-2 infection, PWH did not demonstrate evidence of macrovascular dysfunction and increased CVD risk. Results suggest that CVD risk may not be increased in people with well-controlled HIV who did not manifest CVD complications SARS-CoV-2 infection.

摘要

背景

艾滋病病毒感染者(PWH)发生血管功能障碍和心血管疾病(CVD)的风险增加。严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染与急性心血管疾病并发症有关。本研究的目的是评估轻度SARS-CoV-2感染后艾滋病病毒感染者心血管疾病风险的早期指标——大血管功能。

方法

招募年龄在20至60岁之间、病毒载量检测不到(RNA<20拷贝/毫升)、接受稳定抗逆转录病毒治疗(≥6个月)且有轻度新型冠状病毒肺炎病史(≥30天)、入组前无任何心血管疾病表现的艾滋病病毒感染者。有糖尿病、终末期肾病、心脏或呼吸系统疾病史的参与者被排除。参与者与疫情前的艾滋病病毒感染者按1:1匹配。比较两组之间的健康调查、心血管疾病风险替代指标和大血管功能(肱动脉血流介导的血管舒张和通过压平式眼压计评估动脉僵硬度)。

结果

共有17名有新型冠状病毒肺炎病史的艾滋病病毒感染者(PWH/COV+)与17名疫情前无新型冠状病毒肺炎的艾滋病病毒感染者(PWH/COV-)匹配。两组之间的平均年龄(45.5岁)、性别(76.5%为男性)、体重指数(27.3)和艾滋病病毒感染持续时间(12.2年)无差异。两组具有可比的心血管疾病危险因素(总胆固醇、低密度脂蛋白、高密度脂蛋白、收缩压和舒张压)。SARS-CoV-2感染30天后,血流介导的动脉扩张或动脉僵硬度测量值无差异。

结论

近期SARS-CoV-2感染后,艾滋病病毒感染者未表现出大血管功能障碍和心血管疾病风险增加的证据。结果表明,未出现心血管疾病并发症的SARS-CoV-2感染且艾滋病病毒得到良好控制的人群,心血管疾病风险可能不会增加。

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