Correlation between cardiovascular risk factors in HIV-infected patients and three highly active anti-retroviral therapy regimens

摘要

Objective: To analyze the correlation between three highly active anti-retroviral therapy (HAART) regimens and cardiovascular risk factors in patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). Methods: One hundred and eight patients with HIV/AIDS were randomly divided into three groups. Different HAART regimens were given to each of the groups. Group A: lamivudine + zidovudine + nevirapine; Group B: lamivudine + tenofovir + efavirenz; Group C: lamivudine + tenofovir + lopinavi/ritonavir (LPV/r). CD4(+)T lymphocyte count, body mass index (BMI), ankle-brachial index (ABI), blood pressure, blood sugar, blood lipid and carotid ultrasound were measured before treatment and after 12 months of treatment. Immune reconstitution was assessed after treatment, and changes of cardiovascular risk factors in the three groups were compared. Results: The CD4(+)T lymphocyte count in the three groups after 6, 12, and 24 months of treatment was significantly higher than that before treatment (P<0.05), while the count showed no significant difference among the three groups at each time point (P>0.05). After 24 months of treatment, the cardiovascular risk factors showed significant changes in the three groups (P<0.05), and there were significant differences in the systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), intima-media thickness (IMT) between Group C and Groups A and B (P<0.05); the cardiovascular risk stratification in Group C was more severe than that in Groups A and B (P<0.05); the incidence of hyperglycemia and hypercholesterolemia in Group C was significantly higher than that in Groups A and B (P<0.05). Conclusion: The three HAART regimens have similar effects on immune reconstitution and can lead to increased cardiovascular risk of patients, with the lamivudine + tenofovir + LPV/r group at greatest risk, which needs attention to in clinical work.