围产期感染艾滋病毒者的心血管健康--我们的现状如何?

Edith D Majonga, Merle Henderson, Rashida A Ferrand
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摘要

综述目的:在前抗逆转录病毒疗法(ART)时代,围产期获得性艾滋病病毒感染(PHIV)患儿中的艾滋病病毒相关性心脏病已得到广泛认可。虽然抗逆转录病毒疗法大大提高了患者的存活率,但越来越明显的是,PHIV 感染者仍存在多系统并发症。我们回顾了抗逆转录病毒疗法时代 PHIV 患者的心脏和血管表现:抗逆转录病毒疗法降低了严重心脏疾病的发病率。然而,大量证据表明,在接受抗逆转录病毒疗法的 PHIV 患者中,心脏和血管结构及功能异常(大多为亚临床异常)很常见。在使用的心血管评估类型方面,研究具有相当大的异质性。艾滋病病毒介导的慢性炎症和抗逆转录病毒疗法的潜在影响导致了这些异常。但随着 PHIV 患者年龄的增长和传统风险因素患病率的增加,心血管疾病的负担可能会加重。摘要:了解 PHIV 心血管疾病的发病机制对于制定筛查和干预策略至关重要。还需要进行纵向研究,以了解心血管异常的自然史和临床结果的发生率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cardiovascular health in people with perinatally acquired HIV - where do we stand?

Purpose of review: HIV-associated cardiac disease was well recognized in the preantiretroviral (ART) era among children with perinatally-acquired HIV infection (PHIV). While ART has dramatically improved survival, it has become increasingly apparent that individuals with PHIV continue to experience multisystem co-morbidities. We review the cardiac and vascular manifestations in people growing up with PHIV in the ART era.

Recent findings: ART has resulted in a drop in incidence of serious cardiac morbidity. However, there is a substantial body of evidence that demonstrates that cardiac and vascular structural and functional abnormalities, mostly subclinical, are common in people with PHIV taking ART. Studies have considerable heterogeneity with respect to types of cardiovascular assessments used. HIV-mediated chronic inflammation and potentially effects of ART contribute to these abnormalities. The long-term clinical significance of these abnormalities remains unknown as studies have mainly been cross-sectional, but it is likely that the burden of cardiovascular disease will grow as individuals with PHIV age and the prevalence of traditional risk factors increases.

Summary: Understanding the pathogenesis of cardiovascular disease in PHIV, is critical to inform screening and interventional strategies. Longitudinal studies are also needed to understand the natural history of cardiovascular abnormalities and incidence of clinical outcomes.

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