Investigation On The Status Of Arteriosclerosis In HIV/AIDS Patients With Long-term ART

Objectives:Observe the incidence of peripheral arteriosclerosis and changes in cardiac structure and function in patients with HIV/AIDS who have long received antiretroviral therapy(ART),reveal the influencing factors of atherosclerosis in HIV-infected patients,and provide intervention measures for cardiovascular disease in HIV-infected patients Theoretical basis.Methods:Using the method of cross-sectional survey,select HIV/AIDS patients who have been receiving ART for a long time in the outpatient clinic of the AIDS Care Center of Yunnan Province.They are over 18 years of age,ART time exceeds 240 weeks,HIV-RNA is less than 200 copies/ml,and CD4 is more than 200/Patients with ul,excluding patients in the acute infection period,had opportunistic infection(OI)before ART or during ART.Patients who had virological failure during ART and had a history of alcoholism and could not be terminated.100 cases were enrolled,and cases with incomplete data were excluded,and 95 patients were included in the statistics.According to different ART programs,patients were divided into three groups,group A:AZT/TDF+3TC+NVP;group B:AZT/TDF+3TC+EFV;group C:AZT/TDF+3TC+LPV/r After enrollment,treatment continued according to the original ART protocol,and blood routine,blood lipids,peripheral vascular elasticity,cardiac color Doppler ultrasound examination,and chest X-ray examination were performed.Descriptive statistical analysis of the general situation of patients,univariate and binary unconditional logistic regression analysis of the influencing factors of patients' peripheral arteriosclerosis were used to analyze the risk factors related to arteriosclerosis,and the three groups of blood lipids,arteriosclerosis,high Changes in blood pressure and echocardiography.Results:Among the 95 patients included in the statistics,sexual transmission accounted for 60.01%,of which heterosexual transmission accounted for 37.9%(36/95),and homosexual transmission accounted for 22,11%(21/95).All were male-male homosexual(MSM))Transmission;MSM has a higher education level than patients with heterosexual transmission(P<0.01).The HBsAg positive rate was 8.4%(8/95),and the hepatitis C antibody positive rate was 16.8%(16/95).Echocardiographic examination showed that all indexes except the E/A ratio were within the normal range.Compared with non-hypertensive patients,hypertensive patients had reduced left ventricular diastole,and the difference was statistically significant(P<0.01).This study included 95 patients with HIV/AIDS and 42 patients with arteriosclerosis.The abnormal rate of arteriosclerosis was 44.2%.Compared with non-arteriosclerosis,pulse wave velocity(PWV)is increased(P<0.01),and the mean PWV of arteriosclerosis patients with hypertension is higher than that of arteriosclerosis patients without hypertension(P<0.01)).The diastolic blood pressure and systolic blood pressure in patients with arteriosclerosis were higher than those in patients with non-arteriosclerosis(P<0.01).Univariate and multivariate logistic regression analysis showed that:peripheral arteriosclerosis and gender,ethnicity,age,ART duration,marital status,body mass index(BMI),alcohol consumption,route of infection,high density lipoprotein(HDL-C),total cholesterol(TC),treatment options,ankle-brachial index(ABI),CD4/CD8 ratio,etc.(P>0.05).It is related to education level,low density lipoprotein(LDL-C)and hypertension(P<0.05).Compared with those with junior high school education or above,the probability of atherosclerosis is 8.22 times that of the latter(95%CI:1.78?37.96).Compared with non-hypertensive patients,hypertension has 38.53 times the risk of arteriosclerosis(95%CI:4.47?332.33).The risk of arteriosclerosis in patients with LDL-C>3.1 mmol/L is 4.01 times that of patients with normal LDL-C(95%CI:1.16 to 332.33).Smoking and drinking are not risk factors for arteriosclerosis.Analysis of variance of blood lipid changes in patients in groups A,B,and C showed that:LDL-C in group C was higher than that in groups A and B(P<0.05);there was no statistical difference in TC,HDL-C,and LDH/HDL Academic significance(P>0.05).In this group of patients,18 patients with hypertension,all accompanied by arteriosclerosis,but only 7 people knew they had hypertension,the awareness rate was 38.9%(7/1 8).Conclusions:The incidence of arteriosclerosis in the patients included in this study was 44.2%.Hypertension and arteriosclerosis are risk factors for each other.LDL-C>3.1mmol/L is a risk factor for arteriosclerosis in HIV/AIDS patients.For patients with hypertension and long-term LDL-C>3.1mmol/L,intervention treatment should be carried out in time.The peripheral arteriosclerosis examination was included in routine follow-up.LPV/r can affect lipid metabolism,especially increase LDL-C,and increase the risk of arteriosclerosis.For patients with dyslipidemia and arteriosclerosis,it is not recommended to use LPV/r-containing regimen.For LPV/r-containing regimen Patients should closely monitor changes in blood lipids and give appropriate lipid-lowering therapy.