The Impact of Contemporary Antiretroviral Drugs on Atherosclerosis and Its Complications in People Living With HIV: A Systematic Review

被引:4
作者
Vemulapalli, Abhijith C. [1 ]
Elias, Abanob A. [1 ]
Yerramsetti, Monica D. [1 ]
Olanisa, Olawale O. [1 ]
Jain, Payal [1 ]
Khan, Qasim S. [1 ]
Butt, Samia R. [2 ]
机构
[1] Calif Inst Behav Neurosci & Psychol, Internal Med, Fairfield, CA 94534 USA
[2] Calif Inst Behav Neurosci & Psychol, Gen Practice, Fairfield, CA 94534 USA
关键词
human immunodeficiency virus (hiv) infection; risk factors of atherosclerosis; hiv protease inhibitors; hiv integrase strand transfer inhibitors; people living with hiv (plhiv); major adverse cardiovascular event; antiretroviral drugs; STRAND TRANSFER INHIBITORS; CARDIOVASCULAR-DISEASE; PROTEASE INHIBITOR; INITIAL TREATMENT; OXIDIZED LDL; WEIGHT-GAIN; THERAPY; RISK; DOLUTEGRAVIR; INFECTION;
D O I
10.7759/cureus.47730
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
With the advent of modern antiretroviral therapy (ART), human immunodeficiency virus (HIV) infection has been modified into a chronic manageable condition, prolonging the lifespan of people living with HIV (PLHIV). This has resulted in an increased non-AIDS-related morbidity in the HIV-infected population. Our aim is to study the role of contemporary ART in tackling the risk of atherosclerosis and cardiovascular disease (CVD) in PLHIV. We searched through the databases of PubMed, PubMed Central, and Cochrane Library for pertinent articles using the medical subject headings (MeSH) "HIV infection", "Atherosclerosis", and "Antiretroviral agents". The articles published in the past five years were retrieved, screened for relevance, and assessed for quality before being included in the review. This review was performed following the PRISMA 2020 guidelines. The results indicate that the incidence of dyslipidemia with integrase strand transfer inhibitors (INSTIs) is greater than with non-nucleoside reverse transcriptase inhibitors (NNRTIs) and lesser than with protease inhibitors (PIs). INSTIs are indispensably associated with weight gain and obesity. High triglyceride (TG) and oxidized low-density lipoproteins to low-density lipoproteins (oxLDL/LDL) ratio levels and low high-density lipoprotein (HDL) levels are seen in patients taking PIs. A higher incidence of hypertension and metabolic syndrome (MetS) was noticed with INSTIs compared to NNRTIs. PI intake for >5 years increases the risk of subclinical atherosclerosis. Increased risk of myocardial infarction with INSTIs was observed in a study, while another study reported decreased risk. HIV infection independently increases the risk for atherosclerosis and CVD. Although contemporary ART decreases this enhanced risk, it inherently increases the risk for abnormal lipid profile, MetS, weight gain, and obesity. Further research into the risk of atherosclerosis and CVD with newer ART drugs is essential for decoding the underlying mechanisms and preventing adverse cardiac outcomes in PLHIV.
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页数:15
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