目的:根据国际专家小组的知识和经验,制定共识数据声明和临床建议,为改善艾滋病毒感染者的心脏代谢健康结果提供指导。
方法:有针对性的文献综述,包括281个会议报告,同行评审的文章,我们在2016年1月至2022年4月期间发表了关于成人HIV感染者心脏代谢健康的背景参考文献,并将其用于制定共识数据声明草案.使用改进的Delphi方法,一个由16名专家组成的国际小组在研讨会上召集并完成了调查,以完善共识数据声明并提出临床建议。
结果:总体而言,10个数据声明,5个数据缺口和14个临床建议达成共识.在数据语句中,该小组描述了与普通人群相比,艾滋病毒感染者心脏代谢健康问题的风险增加,已知的危险因素,以及抗逆转录病毒疗法的潜在影响。该小组还确定了数据差距,为未来对艾滋病毒感染者的研究提供信息。最后,在临床建议中,该小组强调需要采取全面的综合护理方法,包括定期评估心脏代谢健康,获得心脏代谢健康服务,在开始或转换抗逆转录病毒治疗后,就体重的潜在变化提供咨询,并鼓励健康的生活方式以降低心脏代谢健康风险。
结论:根据现有数据和专家共识,一个国际小组制定了临床建议,以解决HIV感染者心脏代谢紊乱风险增加的问题,以确保对该人群进行适当的心脏代谢健康管理.
To develop
consensus data statements and clinical recommendations to provide guidance for improving cardiometabolic health outcomes in people with HIV based on the knowledge and experience of an international panel of experts.
A targeted literature review including 281 conference presentations, peer-reviewed articles, and background references on cardiometabolic health in adults with HIV published between January 2016 and April 2022 was conducted and used to develop draft
consensus data statements. Using a modified Delphi method, an international panel of 16 experts convened in workshops and completed surveys to refine
consensus data statements and generate clinical recommendations.
Overall, 10 data statements, five data gaps and 14 clinical recommendations achieved
consensus. In the data statements, the panel describes increased risk of cardiometabolic health concerns in people with HIV compared with the general population, known risk factors, and the potential impact of antiretroviral therapy. The panel also identified data gaps to inform future research in people with HIV. Finally, in the clinical recommendations, the panel emphasizes the need for a holistic approach to comprehensive care that includes regular assessment of cardiometabolic health, access to cardiometabolic health services, counselling on potential changes in weight after initiating or switching antiretroviral therapy and encouraging a healthy lifestyle to lower cardiometabolic health risk.
On the basis of available data and expert
consensus, an international panel developed clinical recommendations to address the increased risk of cardiometabolic disorders in people with HIV to ensure appropriate cardiometabolic health management for this population.