Systematic review on cumulative HIV viraemia among people living with HIV receiving antiretroviral treatment and its association with mortality and morbidity.
IF 2.3 4区 医学Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Anita Mesic, Tom Decroo, Eric Florence, Koert Ritmeijer, Josefien van Olmen, Lutgarde Lynen
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引用次数: 0
Abstract
Background: We performed a systematic review to generate evidence on the association between cumulative human immunodeficiency virus (HIV) viraemia and health outcomes.
Methods: Quantitative studies reporting on HIV cumulative viraemia (CV) and its association with health outcomes among people living with HIV (PLHIV) on antiretroviral treatment (ART) were included. We searched MEDLINE via PubMed, Embase, Scopus and Web of Science and conference abstracts from 1 January 2008 to 1 August 2022.
Results: The systematic review included 26 studies. The association between CV and mortality depended on the study population, methods used to calculate CV and its level. Higher CV was not consistently associated with greater risk of acquire immunodeficiency syndrome-defining clinical conditions. However, four studies present a strong relationship between CV and cardiovascular disease. The risk was not confirmed in relation of increased hazards of stroke. Studies that assessed the effect of CV on the risk of cancer reported a positive association between CV and malignancy, although the effect may differ for different types of cancer.
Conclusions: CV is associated with adverse health outcomes in PLHIV on ART, especially at higher levels. However, its role in clinical and programmatic monitoring and management of PLHIV on ART is yet to be established.
背景:我们进行了一项系统综述,以产生关于累积性人类免疫缺陷病毒(HIV)病毒血症与健康结果之间关系的证据。方法:纳入关于HIV累积性病毒血症(CV)及其与接受抗逆转录病毒治疗的HIV感染者(PLHIV)健康结果的相关性的定量研究。2008年1月1日至2022年8月1日,我们通过PubMed、Embase、Scopus和Web of Science以及会议摘要搜索了MEDLINE。结果:系统综述包括26项研究。CV与死亡率之间的相关性取决于研究人群、计算CV的方法及其水平。较高的CV与定义临床条件的获得性免疫缺陷综合征的风险较高并不一致。然而,有四项研究表明CV与心血管疾病之间存在密切关系。该风险未被证实与中风风险增加有关。评估CV对癌症风险的影响的研究报告了CV与恶性肿瘤之间的正相关,尽管不同类型的癌症的影响可能不同。结论:CV与接受抗逆转录病毒治疗的PLHIV患者的不良健康结果有关,尤其是在较高水平时。然而,它在抗逆转录病毒疗法PLHIV的临床和计划监测和管理中的作用尚待确定。
期刊介绍:
International Health is an official journal of the Royal Society of Tropical Medicine and Hygiene. It publishes original, peer-reviewed articles and reviews on all aspects of global health including the social and economic aspects of communicable and non-communicable diseases, health systems research, policy and implementation, and the evaluation of disease control programmes and healthcare delivery solutions.
It aims to stimulate scientific and policy debate and provide a forum for analysis and opinion sharing for individuals and organisations engaged in all areas of global health.