HIV感染治疗期间体重增加的临床后果。

Current opinion in HIV and AIDS Pub Date : 2024-01-01 Epub Date: 2023-11-06 DOI:10.1097/COH.0000000000000829
Andrew Hill, Willem Daniel Francois Venter
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引用次数: 0

摘要

综述目的:在公共卫生HIV项目中引入口服整合酶抑制剂多卢特格拉韦是成功的,具有良好的持续病毒载量抑制、持久性和安全性。最初对整合酶抑制剂与免疫重建炎症综合征(IRIS)、神经管缺陷和体重增加的安全性担忧有关的担忧已基本平息,但对心血管风险的新担忧已经出现,包括高血压和这类抗逆转录病毒之间的联系。最近的发现:我们在这里回顾了相关的研究,虽然我们在一些但不是所有的研究中都发现了观察性和随机对照研究的关联,但这些关联往往与相关的体重增加和衰老相混淆。此外,高血压的定义以及研究中的测量(如袖带大小)在研究中并不一致。总结:在确定原因之前,需要仔细分析体重增加信号,尤其是在血压升高的合理生理机制尚不清楚的情况下。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical consequences of weight gain during treatment for HIV infection.

Purpose of review: The introduction of dolutegravir, an oral integrase inhibitor, within public health HIV programs has been a success, with excellent sustained viral load suppression, persistence, and safety. Initial concerns around integrase-inhibitors being implicated in safety concerns around immune reconstitution inflammatory syndromes (IRIS), neural tube defects, and weight gain, have been largely laid to rest, but new concerns about cardiovascular risk have arisen, including a link between hypertension and this antiretroviral class.

Recent findings: We review the pertinent studies here, and while we find both observational and randomized controlled study associations in some but not all studies, these are often confounded by associated weight gain and aging. In addition, definitions of hypertension, as well as measurement within the studies (such as cuff size), were not consistent within studies.

Summary: Careful analysis will be needed, as with the weight-gain signal, before assigning causation, especially as plausible physiological mechanisms for this rise in blood pressure are unclear.

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