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首页> 外文期刊>Journal of Infection >Lipid lowering effects of statins and fibrates in the management of HIV dyslipidemias associated with antiretroviral therapy in HIV clinical practice.
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Lipid lowering effects of statins and fibrates in the management of HIV dyslipidemias associated with antiretroviral therapy in HIV clinical practice.

机译：他汀类药物和贝特类药物降低血脂的作用在HIV临床实践中与抗逆转录病毒疗法相关的HIV血脂异常的管理中。

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Objectives. Dyslipidemia associated with antiretroviral therapy is a common clinical problem among HIV-infected patients. Considering that the challenge of adherence to drugs (both antiretroviral and lipid lowering) may be substantial in routine HIV care, our objective was to evaluate the lipid-lowering effects of statins and fibrates in the management of HIV dyslipidemias in clinical practice setting. Methods. Retrospective review of 103 ethnically diverse dyslipidemic HIV patients on antiretroviral therapy treated with lipid-lowering drugs (using National Cholesterol Education and Prevention II [NCEP II] guidelines) who were followed for a median of 70 weeks. Results. An overall mean reduction of 16% in total cholesterol, 20% non-HDL cholesterol, and 18% in triglycerides was noted. There were no significant changes in HDL levels. On evaluation of the different drug classes, the mean (median) change in total cholesterol, were -9 (-7)% with fibrates, -11 (-14)% with statins and -23 (-22)% for dual therapy with fibrates and statins. The triglycerides decreased by -11 (-40)% in those treated with fibrates; -1 (-21)% in those with statins alone, and -32 (-42)% in those with dual therapy. Overall less than a fifth of patients reached the defined NCEP target goal reduction. On logistic regression analysis, only stopping protease inhibitors/ritonavir was independently associated with significant cholesterol reduction (OR: 10.14; 95% CI: 2.1-48.9; p<0.005). Conclusion. In a primary care setting, the use of statins and/or fibrates may add to the complexity of HIV care, with only modest lipid lowering effects.
机译：目标。与抗逆转录病毒疗法相关的血脂异常是艾滋病毒感染患者的常见临床问题。考虑到常规HIV护理中对药物依从性的挑战（抗逆转录病毒和降脂两者）可能很大，因此我们的目标是评估在临床实践中，他汀和贝特类药物在降低HIV血脂异常中的降脂作用。方法。回顾性研究了103名使用降脂药物（根据美国国家胆固醇教育和预防II [NCEP II]指南）接受抗逆转录病毒疗法治疗的HIV血脂异常的不同种族的艾滋病患者，随访时间中位数为70周。结果。总体总胆固醇降低了16％，非HDL胆固醇降低了20％，甘油三酸酯降低了18％。 HDL水平无明显变化。在评估不同的药物类别时，总胆固醇的平均（中位数）变化是：贝特类药物为-9（-7）％，他汀类药物为-11（-14）％，双药联合使用时为-23（-22）％贝特类和他汀类药物。用贝特类药物治疗的人的甘油三酸酯减少了-11（-40）％;单独使用他汀类药物的患者为-1（-21）％，采用双重疗法的患者为-32（-42）％。总体上，不到五分之一的患者达到了确定的NCEP目标降低目标。在逻辑回归分析中，仅停止蛋白酶抑制剂/利托那韦与胆固醇的显着降低独立相关（OR：10.14; 95％CI：2.1-48.9; p <0.005）。结论。在初级保健机构中，他汀类药物和/或贝特类药物的使用可能会增加HIV保健的复杂性，并且仅具有适度的降脂作用。

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