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未得到控制的艾滋病病毒(HIV)感染是心血管疾病(CVD)的独立危险因素。抗反转录病毒治疗(ART)明显改善了HIV感染者的预后,降低了HIV感染所致的CVD风险。但是,ART药物可引起血脂代谢紊乱,从而影响CVD患病风险。艾滋病患者生存期的延长以及ART所引起的血脂异常,增加了艾滋病患者患CVD的风险。但是ART对于降低发病率和病死率的益处远超过了ART引起的CVD风险的增加。与ART药物相比,传统的CVD危险因素可能对CVD有更为负面的影响。临床医生应对每位HIV感染者进行CVD危险性评估,并将对其处理和干预作为整个医疗关怀的一部分。在临床实践中,尽可能选择对血脂代谢影响小的抗病毒药物,在更换抗病毒治疗方案时应权衡药物疗效和不良反应之间的关系,在选择降血脂药物时应注意药物间的相互作用。
Uncontrolled HIV infection is an independent risk factor for cardiovascular disease (CVD). Anti-retroviral therapy (ART) significantly improves the prognosis of HIV-infected individuals and reduces the risk of CVD due to HIV infection. However, ART drugs can cause dyslipidemia, thus affecting the risk of CVD. The prolonged survival of AIDS patients and the dyslipidemia caused by ART increase the risk of CVD among AIDS patients. However, the benefits of ART in reducing morbidity and mortality far outweigh the increased CVD risks associated with ART. Traditional CVD risk factors may have a more negative impact on CVD than ART drugs. Clinicians should assess the risk of CVD in each HIV-infected individual and will include their treatment and intervention as part of their overall medical care. In clinical practice, as far as possible the choice of antiviral drugs with little effect on blood lipid metabolism should be weighed in the relationship between drug efficacy and adverse reactions in the replacement of antiviral treatment programs, the choice of lipid-lowering drugs should pay attention to drug-drug interactions .