Dislipidemia and systemic inflammation in HIV-infected patients against combined antiretroviral therapy.
DOI:
https://doi.org/10.26641/2307-0404.2018.1(part1).127203Ключові слова:
HIV-infection, CD4 T-lymphocytes, high-sensitivity C-reactive protein, lipidogramАнотація
There were screened 142 HIV-infected patients receiving combined antiretroviral therapy (сART) for at least 6 months and who reached a level of viral load (HIV-RNA) less than 50 copies/ml and without clinical manifestations of cardiovascular disease. The study did not include patients with acute inflammation, the number of CD4 + T lymphocytes less than 200 cells/ml, patients with drug addiction and alcoholism. The aim of the study was to establish the severity of dyslipidemia and systemic inflammation in HIV-infected patients, depending on the level of CD4 + T-lymphocytes. It has been established that among patients with HIV receiving сART for a long time, a highly aterogeneic dyslipidemia IIb according to the classification D. Fredrickson develops. Negative prognosis for the course of atherosclerosis in this category of patients is confirmed by a high concentration of С-reactive protein (CRP). An effective сART promotes the reduction of levels of total cholesterol, triglycerides and atherogenicity index against the background of increased high density lipoproteins. At the same time, the concentration of low density lipoproteins does not change and the level of CRP does not decrease sufficiently, which indicates to an unfavorable prognosis for the risk of atherosclerosis progression and cardiovascular complications in HIV-infected patients.Посилання
Zhukova VA, Shalnova SA,MetelskayaVA.[C-reactive protein: the current state of the problem]. Kardiovaskulyarnaya terapiya i profilaktika. 2011;1:90-95. Russian.
Lutai MI. [Atherosclerosis: a modern view of pathogenesis]. Ukrainsky kardiologіchny Journal. 2004;1:22-34. Russian.
D’Ascenzo F, Cerrato E, Calcagno A, et al. High prevalence at computed coronary tomography of non-calcified plaques in asymptomatic HIV patients treated with HAART: a meta-analysis. Atherosclerosis. 2015;240:197-204.
Koening W, Frohlich M, et al. C-reactive protein a sensitive marker of inflammation, predict future risk of coronary heart diseasein initially healthy middle-aged men. Results from MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) Ausburg Cohort study, 1984 to1992. Circulation. 1999;99:237-42.
Chetty R, Batitang S, Nair R. Large artery vasculopathy in HIV-positive patients: another vasculitic enigma. Hum Pathol. 2000;31:374-9.
Lang S, Boccara F, Mary-Krause M, et al. Epidemiology of coronary heart disease in HIVinfected versus uninfected individuals in developed countries. Arch Cardiovasc Dis. 2015;108:206-15.
Estrada V, Portilla J. Dyslipidemia related to antiretroviral therapy. AIDS Rev. 2011;13:49-56.
Haverkate F, Thompson S, Pyke S. Production of C-reactive protein and risk of coronary events in stable and unstable angina. Lancet. 1997;349:462-6.
Vachiat А, McCutcheon К, Tsabedze N, et al. HIV and Ischemic Heart Disease J Am Coll Cardiol 2017;69(1):73-82.
Hulten E, Mitchell J, Scally J, et al. HIV positivity, protease inhibitor exposure and subclinical atherosclerosis: a systematic review and meta-analysis of observational studies. Heart 2009;95:1826-35.
TriantVA, Lee H, Hadigan C, et al. Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease. J Clin Endocrinol Metab. 2007;92:2506-12.
Kuller LH, Tracy RP, Shaten J. Relation of C-reactive protein and coronary heart disease in the MRFIT nested case-control study. Am J Epidemiol. 1996;144:537-47.
Mendall MA, Strachan DP. C-reactive protein: relation to total mortality, cardiovascular risk factors for men. Eur Heart J. 2001;21:2584-90.
Ridker PM. C-reactive protein and the prediction of cardiovascular events among those at intermediate risk. JACC. 2007;49:2129-38.
Robbs JV, Paruk N. Management of HIV vasculopathy: a South African experience. Eur J Vasc Endovasc Surg. 2010;39 Suppl 1:25-31.
Tseng ZH, Secemsky EA, Dowdy D, et al. Sudden cardiac death in patients with human immunodeficiency virus infection. J Am Coll Cardiol 2012;59:1891-6.
##submission.downloads##
Як цитувати
Номер
Розділ
Ліцензія
Авторське право (c) 2018 Медичні перспективи
Ця робота ліцензується відповідно до Creative Commons Attribution 4.0 International License.
Submitting manuscript to the journal "Medicni perspektivi" the author(s) agree with transferring copyright from the author(s) to publisher (including photos, figures, tables, etc.) editor, reproducing materials of the manuscript in the journal, Internet, translation into other languages, export and import of the issue with the author’s article, spreading without limitation of their period of validity both on the territory of Ukraine and other countries. This and other mutual duties of the author and all co-authors separately and editorial board are secured by written agreement by special form to use the article, the sample of which is presented on the site.
Author signs a written agreement and sends it to Editorial Board simultaneously with submission of the manuscript.