cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2023-3370cardiovascular-3370Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEW ARTICLESВИЧ-инфекция и патология сердечно-сосудистой системыHIV infection and cardiovascular pathologyhttps://orcid.org/0000-0002-6110-8504ШеховцоваТ. А.ShekhovtsovaT. A.

Шеховцова Татьяна Андреевна — врач-кардиолог.

Самара

Samara

tshechovtsova@gmail.comhttps://orcid.org/0000-0002-6453-2976ДупляковД. В.DuplyakovD. V.

Дупляков Дмитрий Викторович — доктор медицинских наук, профессор, заместитель главного врача по медицинской части СОККД им. В.П. Полякова; заведующий кафедрой пропедевтической терапии СамГМУ.

Самара

Samara

duplyakov@yahoo.comСамарский областной клинический кардиологический диспансер им. В.П. ПоляковаРоссияPolyakov Samara Regional Clinical Cardiology DispensaryRussian FederationСамарский областной клинический кардиологический диспансер им. В.П. Полякова; Самарский государственный медицинский университет Минздрава РоссииРоссияPolyakov Samara Regional Clinical Cardiology Dispensary; Samara State Medical UniversityRussian Federation20231004202322333703370Copyright © Шеховцова Т.А., Дупляков Д.В., 20232023Шеховцова Т.А., Дупляков Д.В.Shekhovtsova T.A., Duplyakov D.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/3370

Согласно современным литературным данным, доказана роль инфекции, вызываемой вирусом иммунодефицита человека (ВИЧ-инфекции), как независимого фактора риска (ФР) развития атеросклероза и сердечно-сосудистых заболеваний (ССЗ), в т.ч. ишемической болезни сердца, сердечной недостаточности и внезапной сердечной смерти. Роль антиретровирусной терапии (АРТ) в возникновении ССЗ остается дискутабельной. С одной стороны, прием АРТ — обязательный компонент в профилактике ССЗ, т.к. имеются многочисленные подтверждения ассоциации высокой вирусной нагрузки и некомпенсированного иммунного статуса с повышением риска возникновения ССЗ. С другой стороны, применение некоторых классов препаратов АРТ ассоциировано с развитием дислипидемии, резистентности к инсулину и сахарного диабета 2 типа, которые являются ФР ССЗ. В связи с этим действующие протоколы лечения ВИЧ предполагают оценку ФР ССЗ для подбора оптимальной схемы АРТ. Необходимо помнить, что при применении общепринятых алгоритмов и шкал оценки риска ССЗ, реальный риск может остаться недооцененным у ВИЧ-инфицированных пациентов. В настоящем литературном обзоре представлен алгоритм ведения данных пациентов, разработанный Американской ассоциацией сердца, описаны особенности статинотерапии у пациентов с ВИЧ-инфекцией.

According to modern literature data, the role of human immunodeficiency virus (HIV) infection has been proven as an independent risk factor (RF) for atherosclerosis and cardiovascular diseases (CVDs), including coronary artery disease, heart failure, and sudden cardiac death. The role of antiretroviral therapy (ART) in the occurrence of CVD remains debatable. On the one hand, ART is a mandatory component in CVD prevention, since there are numerous confirmations of the association of high viral load and noncompensated immune status with an increased risk of CVD. On the other hand, the use of certain classes of ART agents is associated with the development of dyslipidemia, insulin resistance, and type 2 diabetes, which are risk factors for CVD. In this regard, the current HIV treatment protocols require an assessment of CVD risk factors to select the optimal ART regimen. It must be remembered that when using generally accepted algorithms and scales for assessing the risk of CVD, the real risk may remain underestimated in HIV-infected patients. This literature review presents a patient data management algorithm developed by the American Heart Association and describes statin therapy in patients with HIV infection.

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The authors declare that there are no conflicts of interest present.