2018年深圳市初治HIV感染者血脂异常患病率及影响因素分析

孙丽琴; 刘甲野; 王　辉; 徐六妹; 周　泱; 张路坤; 赵　方; 何　云

文章摘要

2018年深圳市初治HIV感染者血脂异常患病率及影响因素分析

Prevalence and influencing factors of dyslipidemia among treatment-naive HIV-infected individuals in Shenzhen in 2018

DOI：10.3969/j.issn.1007-8134.2020.02.006

中文关键词: 人类免疫缺陷病毒血脂异常患病率危险因素

英文关键词: HIV dyslipidemia prevalence risk factor

基金项目:国家科技重大专项（2017ZX10202101-001-008）

作者	单位
孙丽琴	深圳市第三人民医院感染一科
刘甲野	深圳市第三人民医院感染一科
王　辉	深圳市第三人民医院感染一科
徐六妹	深圳市第三人民医院感染一科
周　泱	深圳市第三人民医院感染一科
张路坤	深圳市第三人民医院感染一科
赵　方	深圳市第三人民医院感染一科
何　云	深圳市第三人民医院感染一科

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中文摘要:

目的　了解深圳市初治HIV感染者血脂异常的患病率及其高危因素。方法　以2018年深圳市第三人民医院收治的未接受过抗反转录病毒治疗的成年HIV感染者作为研究对象，收集其基本特征和临床资料，分析纳入对象的TC、TG、LDL-C和HDL-C的平均水平，血脂异常总患病率及高TC、高TG、高LDL-C和低HDL-C的患病率。采用多变量Logistic回归模型分析各项血脂异常的影响因素。结果　共纳入1195例初治HIV感染者，血脂异常率为49.04%（586/1195），其中男、女患病率分别为49.86%和39.80%（χ2=3.649，P=0.056）；高TC、高TG、高LDL-C和低HDL-C的比率分别为13.31%（159/1195）、15.40%（184/1195）、33.72%（403/1195）和9.21%（110/1195）。多因素分析结果显示，年龄大（≥35岁）和肥胖是高TC的独立危险因素；年龄大、超重、肥胖、CD4/CD8比值低是高TG的独立危险因素；男性、糖尿病、超重、肥胖、CD4/CD8比值低、WHO HIV临床分期IV期、HIV RNA≥105 IU/ml是低HDL-C的危险因素；糖尿病、超重、肥胖、CD4/CD8比值低、HIV RNA载量≥105 IU/ml是高LDL-C的危险因素。结论　初治HIV感染者血脂异常的患病率高，影响血脂异常的危险因素包括以年龄大、超重、肥胖、糖尿病等为主的传统因素和以低CD4/CD8比值、WHO HIV临床分期晚、高HIV RNA载量等为主的HIV感染相关因素。建议在临床上对初治的HIV感染者常规筛查血脂，对具有其他代谢异常因素的WHO HIV临床分期晚期人群进行重点的筛查和评估。

英文摘要:

Objective　To explore the prevalence of dyslipidemia and its high-risk factors among treatment-naive HIV-infected individuals in Shenzhen, China. Methods　Antiretroviral therapy-naive HIV-infected adults who were treated in Shenzhen Third People’s Hospital in 2018 were enrolled in the study. Their general data and clinical information were collected. The average levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), the overall prevalence of dyslipidemia, and the prevalences of high TC, high TG, high LDL-C and low HDL-C were analyzed. The influencing factors of dyslipidemia were analyzed using multivariate Logistic regression model. Results　A total of 1195 antiretroviral therapy-naive HIV-infected individuals were enrolled in this study. The overall prevalence of dyslipidemia was 49.04% (586/1195), and that in males and females was 49.86% and 39.80%, respectively (χ2=3.65, P=0.060). The prevalences of high TC, high TG, high LDL-C, and low HDL-C was 13.31% (159/1195), 15.40% (184/1195), 33.72% (403/1195) and 9.21% (110/1195), respectively. Multivariate analysis showed that the elderly (≥ 35 years old) and obesity were the independent risk factors of high TC. The elderly, overweight, obesity and low CD4/CD8 ratio were the independent risk factors of high TG. The male, diabetes, overweight, obesity, low CD4/CD8 ratio, WHO HIV clinical staging at IV stage, and HIV RNA ≥105 IU/mL were the risk factors of low HDL. The diabetes, overweight, obesity, low CD4/CD8 ratio, and HIV RNA ≥105 IU/mL were the risk factors of high LDL-C. Conclusions　The prevalence of dyslipidemia is high in treatment-naive HIV-infected individuals. The classical factors including the elderly, overweight, obesity, and diabetes, and factors associated with HIV infection including low CD4/CD8 ratio, advanced stage in WHO HIV clinical staging, and high HIV RNA load are the risk factors of dyslipidemia. This study suggests that the routine screening of dyslipidemia for treatment-naive HIV-infected individuals screening and evaluation for those with abnormalities of other metabolism related factors at advanced HIV stage are essential in clinic.

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