Abstract:
An extremely high prevalence (12.2%) of moderate-to-severe coronary artery stenosis (CAS) was documented in asymptomatic Japanese haemophiliacs living with HIV-1 (JHLH) in our previous study. The cause of this phenomenon remains unknown. We conducted the CAS screening in people living with HIV-1 without haemophilia (PLWH without haemophilia) to compare the prevalence of CAS in JHLH and PLWH without haemophilia and to identify the risk factors including inflammation markers. Ninety-seven age-matched male PLWH without haemophilia who consulted our outpatient clinic between June and July 2021 were randomly selected, and 69 patients who provided informed consent were screened for CAS using coronary computed tomography angiography (CCTA). The number of JHLH cases was 62 in this study. The prevalence of moderate (> 50%) to severe (> 75%) CAS was significantly higher in JHLH [14/57 (24.6%) vs. 6/69 (8.7%), p = 0.015], and the ratio of CAS requiring urgent interventions was significantly higher [7 (12.3%) vs. 1 (1.4%), p = 0.013] in JHLH than in PLWH without haemophilia. Among the inflammatory markers, serum titres of intercellular adhesion molecule-1 (p < 0.05) and interleukin-6 (p < 0.05) in JHLH were significantly higher than those in PLWH without haemophilia. Although some patient demographics were different in the age-matched study, it might be possible to speculate that intravascular inflammation might promote CAS in JHLH.
摘要:
在我们先前的研究中,无症状的感染HIV-1(JHLH)的日本血友病患者中,中度至重度冠状动脉狭窄(CAS)的患病率极高(12.2%)。这种现象的原因仍然未知。我们在无血友病(PLWH无血友病)的HIV-1感染者中进行了CAS筛查,以比较无血友病的JHLH和PLWH中CAS的患病率,并确定包括炎症标志物在内的危险因素。随机选择在2021年6月至7月期间咨询我们门诊诊所的97名年龄匹配的无血友病男性PLWH,和69例提供知情同意的患者使用冠状动脉计算机断层扫描血管造影术(CCTA)筛查CAS.本研究中JHLH病例数为62。在JHLH中,中度(>50%)至重度(>75%)CAS的患病率明显更高[14/57(24.6%)与6/69(8.7%),p=0.015],需要紧急干预的CAS比例明显更高[7(12.3%)与1(1.4%),JHLH的p=0.013]比没有血友病的PLWH。在炎症标志物中,JHLH的细胞间粘附分子-1(p<0.05)和白细胞介素-6(p<0.05)的血清滴度显着高于无血友病的PLWH。尽管在年龄匹配的研究中,一些患者的人口统计数据有所不同,有可能推测血管内炎症可能促进JHLH中的CAS.