HIV相关动脉粥样硬化性心血管疾病的发病机制研究进展

Research advances in the mechanisms of HIV-related atherosclerotic cardiovascular disease

抗病毒逆转录治疗(antiretroviral therapy,ART)的发展进步使得艾滋病成为一种可控的慢性病。人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染会引起潜在的心血管并发症并增加心血管疾病风险,包括心肌梗死、卒中、外周动脉疾病、心源性猝死和心力衰竭,但发病机制复杂且尚不明确。本文就HIV相关动脉粥样硬化性心血管疾病的发病机制研究进展进行综述,包括HIV病毒蛋白的直接作用、HIV感染引起的免疫缺陷、共感染巨细胞病毒、细菌易位、慢性炎症和免疫激活、ART相关机制等。

The development and implementation of antiretroviral therapy(ART)has transformed human immunodeficiency virus(HIV)infection into a controllable chronic condition.HIV infection can cause potential cardiovascular complications and increase the risk of cardiovascular disease along with myocardial infarction,stroke,peripheral arterial disease,sudden cardiac death,and heart failure.However,the pathogenesis of atherosclerosis in the setting of HIV infection is complex and unclear.In this review,we discuss the mechanisms of HIV-associated atherosclerotic cardiovascular disease,including the effects of the viral proteins on immune and vascular cells,the immunodeficiency caused by the HIV infection,co-infection with cytomegalovirus(CMV),microbial translocation,chronic inflammation and immune activation,and a few ART-related mechanisms.