Muga R, Tor J, Rey-Joly C, Pardo A, Llobet P, Foz M
Servicio de Medicina Interna, Hospital Universitario Germans Trias i Pujol, Badalona.
Med Clin (Barc). 1993 Feb 6;100(5):161-3.
It has been demonstrated that hypertriglyceridemia and hypocholesterolemia are frequent signs in homosexual patients with AIDS. Lipid abnormalities of the intravenous drug addict (IVDA) however, and its relation with infection by the human immunodeficiency virus (HIV) have not been sufficiently studied.
Four hundred thirty-five consecutive patients attended for infectious complications or for carrying out detoxication treatment were studied. Demographic (age, sex), anthropometric (weight, height), use of intravenous drugs (principal drug used, time of addiction) and analytic data (HIV-1 antibodies, total lymphocytes, CD4+ lymphocytes, serum albumin, total cholesterol, plasma triglycerides and transferrinemia) were collected.
The age of the patients was found to be between 15-44 years of age. Ninety-five percent were heroin addicts with a time of addiction greater than 4 years. Those who were HIV-1 positive had been drug users for a longer period of time (p < 0.01), had less weight (p < 0.01), lower albuminemia (p < 0.05) and cholesterolemia (p < 0.01), as well as a lower number of CD4+ lymphocytes (p < 0.01). No differences were observed with regard to age, transferrinemia and plasma triglyceride concentration. The prevalence of hypertriglyceridemia (> 1.97 mmol/l; 175 mg/dl) was of 18% for the IVDA with HIV-1 infection and 23% for seronegative individuals (p = 0.3). Hypercholesterolemia was significantly more prevalent in HIV-1 positive individuals (20%) than in the seronegative subjects (9%) (p < 0.01). In the HIV-1 positive patients, most of whom where asymptomatic, a decrease in total cholesterol and an increase in plasma triglycerides was observed according to the decrease in the number of CD4+ lymphocytes.
Infection by the human immunodeficiency virus is accompanied by an increase in plasma triglycerides and a decrease of total cholesterol in relation with the alteration of cellular immunity. However, heroin addicts present some differential characteristics similar to those of chronic alcoholics, poor diet, anorexia induced by opioids, autoimmunity phenomena and recurrent infections throughout drug addiction which may justify lipid abnormalities of multifactorial origin.
已有研究表明，高甘油三酯血症和低胆固醇血症是艾滋病同性恋患者的常见体征。然而，静脉注射吸毒者（IVDA）的脂质异常及其与人类免疫缺陷病毒（HIV）感染的关系尚未得到充分研究。
对连续435例因感染并发症或进行戒毒治疗而就诊的患者进行研究。收集人口统计学数据（年龄、性别）、人体测量数据（体重、身高）、静脉吸毒情况（主要使用的毒品、成瘾时间）和分析数据（HIV-1抗体、总淋巴细胞、CD4 +淋巴细胞、血清白蛋白、总胆固醇、血浆甘油三酯和转铁蛋白血症）。
患者年龄在15至44岁之间。95%为海洛因成瘾者，成瘾时间超过4年。HIV-1阳性者吸毒时间更长（p < 0.01），体重更轻（p < 0.01），白蛋白血症和胆固醇血症更低（p < 0.05和p < 0.01），CD4 +淋巴细胞数量也更少（p < 0.01）。在年龄、转铁蛋白血症和血浆甘油三酯浓度方面未观察到差异。HIV-1感染的IVDA中高甘油三酯血症（> 1.97 mmol/l；175 mg/dl）的患病率为18%，血清阴性者为23%（p = 0.3）。高胆固醇血症在HIV-1阳性个体（20%）中比血清阴性个体（9%）更普遍（p < 0.01）。在HIV-1阳性患者中，大多数无症状，随着CD4 +淋巴细胞数量的减少，总胆固醇降低，血浆甘油三酯升高。
人类免疫缺陷病毒感染伴随着血浆甘油三酯升高和总胆固醇降低，与细胞免疫改变有关。然而，海洛因成瘾者具有一些与慢性酒精中毒者、不良饮食、阿片类药物引起的厌食、自身免疫现象以及整个吸毒过程中的反复感染相似的差异特征，这可能解释了多因素导致的脂质异常。
