HIV 控制者的功能性和结构性神经视网膜病变。前瞻性队列研究。

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES

HIV Medicine Pub Date : 2024-07-09 DOI:10.1111/hiv.13685

Susana Ruiz-Bilbao, Sebastian Videla, Ester Pascual, Montse Soler, Puig Jordi, Stefano Grizolli, Eugènia Negredo, Jordi Castellvi-Manent

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引用次数: 0

摘要

目的估计 HIV 控制者中神经视网膜障碍（NRD）的流行率和累积发病率：设计：对 HIV 感染者（PLWH）：精英控制者、长期未进展者和早期诊断者进行前瞻性、单中心、队列研究：研究比较了未接受抗逆转录病毒疗法（ART）的 "HIV 控制者"（包括精英控制者和长期未进展者）和 "HIV 治疗者"（近期诊断并接受抗逆转录病毒疗法的 HIV 感染者）。我们还建立了一个 "非 HIV 受试者 "的匹配队列。NRD定义为至少一项眼科参数（功能性或结构性）发生改变（不正常）。对功能参数（视力、对比敏感度、色觉、视野）和结构参数（神经节细胞、黄斑神经纤维层、毛细血管周围神经纤维层、血管口径）以及生活质量（医疗结果研究-HIV简表-30）进行了评估：2012年3月至2015年11月期间，研究对象包括所有HIV控制者（16名精英控制者、1名长期未进展者）、11名HIV治疗者和16名非HIV治疗者。基线NRD患病率分别为88.2%（15/17，95% CI：65.7%-96.7%）、90.9%（10/11，95% CI：62.3%-98.4%）和56.3%（9/16，95% CI：33.2%-76.9%）。3年的累计发病率分别为50%（1/2）、100%（1/1）和33.3%（2/6）。所有参与者均未出现眼部临床症状。三年后，NRD发病率分别为92.3%（12/13，95% CI：66.7%-98.6%）、75%（6/8，95% CI：40.9%-92.9%）和50.0%（7/14，95% CI：26.8%-73.2%）。总体而言，对比敏感度和结构参数对 PLWH 的影响最大。基线和 3 年的生活质量（总分）[中位数（四分位间距）]在 HIV 控制者中分别为 82（71-89）和 74（63.5-79.25），在 HIV 治疗者中分别为 80（73-88）和 88（83-92）：结论：HIV 控制者和接受抗逆转录病毒疗法治疗者的 NRD 百分比高于非 HIV 患者。我们的研究结果表明，NRD可能是艾滋病病毒感染者眼部老化的生物标志物。

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Functional and structural neuroretinal disorders in HIV Controllers. Prospective cohort study.

Objective: To estimate the prevalence and cumulative incidence of neuro-retinal-disorders (NRD) in HIV-controllers.

Design: Prospective, single-centre, cohort study of people living with HIV (PLWH): elite-controllers, long-term-non-progressors and early diagnosed.

Methods: The study compared "HIV-controllers" (including elite-controllers and long-term-non-progressors), who were not on antiretroviral therapy (ART), and "HIV-treatment" (HIV-infected subjects with a recent diagnosis and on ART). A matched cohort of "non-HIV subjects" was created. NRD was defined as at least one altered (not normal) ophthalmological parameter (functional or structural). Functional (visual acuity, contrast sensitivity, chromatic vision, visual field) and structural parameters (ganglion cells, macular nerve fibre layer, peripapillary nerve fibre layers, vascular calibre) as well as quality of life (Medical Outcomes Study-HIV Short Form-30) were assessed.

Results: Between March 2012 and November 2015, the study included all HIV-controllers (16 elite-controllers, 1 long-term-non-progressor), 11 HIV-treatment and 16 non-HIV. Prevalence of NRD at baseline was 88.2% (15/17, 95% CI: 65.7%-96.7%), 90.9% (10/11, 95% CI: 62.3%-98.4%) and 56.3% (9/16, 95% CI: 33.2%-76.9%), respectively. Cumulative incidence at 3 years was 50% (1/2), 100% (1/1) and 33.3% (2/6), respectively. None of the participants manifested ocular clinical symptoms. Three years later, prevalence of NRD was 92.3% (12/13, 95% CI: 66.7%-98.6%), 75% (6/8, 95% CI: 40.9%-92.9%) and 50.0% (7/14, 95% CI: 26.8%-73.2%), respectively. Contrast sensitivity and structural parameters were globally the most affected among PLWH. Quality of life (total score) [median (interquartile range)] at baseline and 3 years was 82 (71-89) and 74 (63.5-79.25) in HIV-controllers and 80 (73-88) and 88 (83-92) in HIV-treatment.

Conclusions: HIV-controllers and those individuals on ART presented a higher percentage of NRD than non-HIV. Our results suggest that NRD could be a biomarker of ocular aging among PLWH.

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来源期刊

HIV Medicine 医学-传染病学

CiteScore

5.10

自引率

10.00%

发文量

167

审稿时长

6-12 weeks

期刊介绍： HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.