Marcadores de riesgo cardiovascular en pacientes VIH/SIDA que reciben terapia atirretroviral / Markers of cardiovascular risk in HIV/AIDS patients receiving therapy atirretroviral

RESUMEN

El uso de la terapia antirretroviral (TARVAE), ha reducido la morbimortalidad entre los pacientes con el VIH; sin embargo, está asociada a la aparición de efectos metabólicos adversos, constituyendo riesgo de enfermedad cardiovascular (ECV). Determinar los marcadores de riesgo cardiovascular en pacientes con el VIH que reciben TARVAE, en la Unidad de Inmunología y Servicio de Infectología del Complejo Hospitalario Universitario "Ruiz y Páez", Ciudad Bolívar, Estado Bolívar, Venezuela, enero-junio 2009. Estudio experimental, de tipo descriptivo, transversal en 54 pacientes con el VIH. 66% masculinos , edad 44 ± 9,96 años, tiempos de diagnóstico 4,36 ± 4,30 años, tiempo de tratamiento 3,78 ± 4,41 años, 81,48% recibieron TARVAE y 42,59% incluían en el esquema de tratamiento al menos un inhibidor de la proteasa. La frecuencia de hipertensión arterial fue 31,18% encontrándose el 22,22% de los hipertensos en el grupo de TRAVAE que no incluyó inhibidores de la proteasa (X²= 5,87, g.l. = 1, P = 0,01), tabaquismo 44,44% historia familiar de enfermedad cardiovascular prematura 57,41% sobrepeso 25,93%, obesidad 20,37%, dislipidemia aislada o combinada en 33,33%, hipercolesterolemia 1,85% LDL elevada 20,36 hipoalfalipoproteinemia 22,22% e hipertrigliceridemia en 18,52%, intolerancia a hidratos de carbono en 27,78%. El riesgo calculado según el Framingham Risk Score fue bajo en el 68,52% moderado en 29,63% y solo el 1,85% tuvo riesgo elevado. No se encontró relación entre el tipo de terapia utilizada y el riesgo a los diez años de ECV (X² = 0,23, g.l. = 1, P = 0,62).

ABSTRACT

The use of antiretroviral therapy (HAART) has reduced morbidity and mortality among HIV patients, however, it is associated with metabolic adverse effects and elevated risk of cardivascular disease (CVD). To determine the cardivascular risk markers in patients with HIV who receive HAART, at the Immunology and Infectology Service, of the Complejo Hospitalario Universitario "Ruiz y Páez" in Cuidad Bolívar, Estado Bolívar, Venezuela, from January to June 2009.Anon-experimental, descriptive, transverse study was performed in 54 patients with HIV. 66% were male, age 44 ± 9.96 years, time of diagnosis 4.36 ± 4.30 years, time of treatment 3.78 ± 4.41 years. 81.48% received HAART of whom 42.59% received at least one protease inhibitor. The frequency of essential hypertension was 31.18% 22.22% of the patients in the HAART group who did not include protease inhibitors were hypertensive (X² = 5.87, df = 1, P = 0.01). 44.44% were current smokers 57.41% had family history of premature cardiovascular disease. 25.93% were overweight and 20.37% were obese. 33.33% had alone or combined dyslipidemia. 1.85% had high cholesterol, 20.36% had high LDL cholesterol, 22.22% had low HDL cholesterol and 18.52% had hypertriglyceridemia. Carbohydrate intolerance was present in 27.78% patients. The risk calculated by the Framingham Risk Score was low in 68.52% patients, moderate in 29.63% patients and 1.85% participants had high risk. No relationship was found between the of type of therapy used and the risk of CVD (X¹ = 0.23, df = 1, P = 0.62).