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Prevention of stroke in people living with HIV.
Progress in Cardiovascular Diseases ( IF 9.1 ) Pub Date : 2020-01-31 , DOI: 10.1016/j.pcad.2020.01.006
Ivy Nguyen 1 , Anthony S Kim 1 , Felicia C Chow 2
Affiliation  

In the era of effective antiretroviral therapy (ART), HIV has become a manageable disease marked by an elevated risk of non-AIDS-related comorbidities, including stroke. Rates of stroke are higher in people living with HIV (PLWH) compared with the general population. Elevated stroke risk may be attributable to traditional risk factors, HIV-associated chronic inflammation and immune dysregulation, and possible adverse effects of long-standing ART use. Tailoring stroke prevention strategies for PLWH requires knowledge of how stroke pathogenesis may differ from non-HIV-associated stroke, knowledge of long-term stroke outcomes in HIV, and accurate stroke risk assessment tools. As a result, the approach to primary and secondary stroke prevention in PLWH relies heavily on guidelines developed for the general population, with an emphasis on optimization of traditional vascular risk factors and early initiation of ART. This review summarizes existing evidence on HIV-associated stroke mechanisms and considerations for stroke prevention for PLWH.

中文翻译:

预防艾滋病毒感染者中风。

在有效的抗逆转录病毒疗法(ART)时代,HIV已成为一种可控制的疾病,其特征是与非AIDS相关的合并症(包括中风)的风险增加。与一般人群相比,HIV感染者(PLWH)的中风发生率更高。中风风险升高可能归因于传统风险因素,与艾滋病毒相关的慢性炎症和免疫功能异常,以及长期使用抗逆转录病毒药物可能产生的不良影响。为PLWH量身定制中风预防策略,需要了解中风发病机制可能与非HIV相关中风有何不同,了解HIV中长期中风预后的知识以及准确的中风风险评估工具。结果,在PLWH中预防一级和二级卒中的方法在很大程度上依赖于为一般人群制定的指南,重点是优化传统血管危险因素和尽早开展抗逆转录病毒疗法。这篇综述总结了有关HIV相关中风机制的现有证据以及对PLWH中风预防的考虑。
更新日期:2020-01-31
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