Antiretroviral therapy and cardiovascular risk: are some medications cardioprotective?

被引：1

作者：

Eckhardt, Benjamin J. ^{[2
]}

Glesby, Marshall J. ^{[1
]}

机构：

[1] Weill Cornell Med Coll, Div Int Med & Infect Dis, Dept Med, New York, NY 10065 USA

[2] Albert Einstein Coll Med, Bronx, NY 10467 USA

来源：

CURRENT OPINION IN HIV AND AIDS | 2008年 / 3卷 / 03期

关键词：

antiretroviral therapy; coronary heart disease; glucose homeostasis; lipids;

D O I：

10.1097/COH.0b013e3282f6451a

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Purpose of review This review addresses the associations between coronary heart disease and antiretroviral medications, with a specific focus on medications that appear to have neutral or positive effects on coronary heart disease risk factors. Recent findings Studies have linked combination antiretroviral therapy with an increased risk of coronary heart disease. Often implicated are the effects of these medications on the metabolic risk factors for coronary heart disease, specifically lipids and glucose homeostasis. Many newer antiretrovirals have fewer metabolic side effects, and antiretrovirals in general may be cardioprotective by reducing inflammation. Whether use of specific antiretroviral regimens will translate into improved cardiovascular outcomes remains to be seen. Summary Some antiretrovirals appear to be at least neutral with regards to coronary heart disease risk, but it is not clear if any are truly cardioprotective. Nonetheless, it is prudent to consider regimens with limited metabolic side effects in patients with pre-established coronary heart disease risk.

引用

页码：226 / 233

页数：8

共 70 条

[1] Hypoadiponectinemia is associated with insulin resistance, hypertriglyceridemia, and fat redistribution in human immunodeficiency virus-infected patients treated with highly active antiretroviral therapy [J].

Addy, CL ;

Gavrila, A ;

Tsiodras, S ;

Brodovicz, K ;

Karchmer, AW ;

Mantzoros, CS .

JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2003, 88 (02) :627-636

[2] Homozygous Delta 32 deletion of the CCR-5 chemokine receptor gene in an HIV-1-infected patient [J].

Balotta, C ;

Bagnarelli, P ;

Violin, M ;

Ridolfo, AL ;

Zhou, D ;

Berlusconi, A ;

Corvasce, S ;

Corbellino, M ;

Clementi, M ;

Clerici, M ;

Moroni, M ;

Galli, M .

AIDS, 1997, 11 (10) :F67-F71

[3] Effects of torcetrapib in patients at high risk for coronary events [J].

Barter, Philip J. ;

Caulfield, Mark ;

Eriksson, Mats ;

Grundy, Scott M. ;

Kastelein, John J. P. ;

Komajda, Michel ;

Lopez-Sendon, Jose ;

Mosca, Lori ;

Tardif, Jean-Claude ;

Waters, David D. ;

Shear, Charles L. ;

Revkin, James H. ;

Buhr, Kevin A. ;

Fisher, Marian R. ;

Tall, Alan R. ;

Brewer, Bryan .

NEW ENGLAND JOURNAL OF MEDICINE, 2007, 357 (21) :2109-2122

[4] Impaired glucose tolerance, beta cell function and lipid metabolism in HIV patients under treatment with protease inhibitors [J].

Behrens, G ;

Dejam, A ;

Schmidt, H ;

Balks, HJ ;

Brabant, G ;

Körner, T ;

Stoll, M ;

Schmidt, RE .

AIDS, 1999, 13 (10) :F63-F70

[5] Antiretroviral therapy and the prevalence and incidence of diabetes mellitus in the Multicenter AIDS Cohort Study [J].

Brown, TT ;

Cole, SR ;

Li, XH ;

Kingsley, LA ;

Palella, FJ ;

Riddler, SA ;

Visscher, BR ;

Margolick, JB ;

Dobs, AS .

ARCHIVES OF INTERNAL MEDICINE, 2005, 165 (10) :1179-1184

[6] Cumulative exposure to nucleoside analogue reverse transcriptase inhibitors is associated with insulin resistance markers in the multicenter AIDS cohort study [J].

Brown, TT ;

Li, XH ;

Cole, SR ;

Kingsley, LA ;

Palella, FJ ;

Riddler, SA ;

Chmiel, JS ;

Visscher, BR ;

Margolick, JB ;

Dobs, AS .

AIDS, 2005, 19 (13) :1375-1383

[7] Coronary heart disease in HIV-infected individuals [J].

Currier, JS ;

Taylor, A ;

Boyd, F ;

Dezii, CM ;

Kawabata, H ;

Burtcel, B ;

Maa, JF ;

Hodder, S .

JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, 2003, 33 (04) :506-512

[8]

de Jesus E, 2007, 47 INT C ANT AG CHEM

[9] Glucose metabolism, lipid, and body fat changes in antiretroviral-naive subjects randomized to nelfinavir or efavirenz plus dual nucleosides [J].

Dubé, MP ;

Parker, RA ;

Tebas, P ;

Grinspoon, SK ;

Zackin, RA ;

Robbins, GK ;

Roubenoff, R ;

Shafer, RW ;

Wininger, DA ;

Meyer, WA ;

Snyder, SW ;

Mulligan, K .

AIDS, 2005, 19 (16) :1807-1818

[10]

El-Sadr WM, 2006, NEW ENGL J MED, V355, P2283, DOI 10.1056/NEJMoa062360

← 1 2 3 4 5 6 7 →