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JCEM:抗逆转录病毒疗法对早期感染HIV的青年人骨骼和肾功能的长期影响

2017-05-27 MedSci MedSci原创

HIV抗逆转录病毒(antiretroviral,ARV)疗法会造成肾毒性和骨髓毒性,但关于成人从出生即暴露于ARV药物的累积效应的报道却很少。因此,研究人员前瞻性评估了终身HIV和广泛ARV暴露的青年人的肾及骨骼健康情况。研究人员对出生即感染HIV的青年人(n = 65)的骨密度(BMD,通过双能x线骨密度检测术测得)、骨转移和肾功能与相匹配的健康对照组(n = 23)进行了横断面对比,同时,在

HIV抗逆转录病毒(antiretroviral,ARV)疗法会造成肾毒性和骨髓毒性,但关于成人从出生即暴露于ARV药物的累积效应的报道却很少。因此,研究人员前瞻性评估了终身HIV和广泛ARV暴露的青年人的肾及骨骼健康情况。

研究人员对出生即感染HIV的青年人(n = 65)的骨密度(BMD,通过双能x线骨密度检测术测得)、骨转移和肾功能与相匹配的健康对照组(n = 23)进行了横断面对比,同时,在一个HIV队列研究的亚组(n=33)里进行了纵向评估(平均随访4.4年)。

研究发现,与对照组对比,HIV感染者的白蛋白/肌酐比值、蛋白/肌酐比值,阴离子隙,胶原蛋白肽和骨钙素均显著增加,而全身BMD和骨密度Z分数降低。HIV组内,替诺福韦酯(TDF)与较高的阴离子隙相关,但不与骨参数相关。长时间使用地达诺新、司他夫定与较低的骨密度和骨密度Z分数相关。纵向分析显示,BMD和骨代谢随着时间的推移显着改善。亚组中没有患者的eGFR<60,但是eGFR的下降与TDF暴露时间的增加有关。

总而言之,HIV感染的青年人的肾功能不全的亚临床标记增加且与TDF暴露相关,而骨密度的降低与地达诺新、司他夫定的使用相关。骨骼健康指标随时间的提高和低毒性抗逆转录病毒药物的替代品的趋势可能预示着围产期感染的患者在成年后肾和骨骼健康状况改善的来临。

原始出处:

Unsal AB1, Mattingly AS,et al.Effect of Antiretroviral Therapy on Bone and Renal Health in Young Adults Infected with HIV in Early Life.J Clin Endocrinol Metab. 2017 May 22. doi: 10.1210/jc.2017-00197. [Epub ahead of print]

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    2017-11-15 zll0625
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    2017-06-21 yese
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    2017-10-03 achengzhao
  4. 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topicName=转录)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58df35929710, createdName=mjldent, createdTime=Wed Feb 14 21:01:00 CST 2018, time=2018-02-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2053182, encodeId=4dd6205318227, content=<a href='/topic/show?id=623294e587c' target=_blank style='color:#2F92EE;'>#逆转录病毒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94758, encryptionId=623294e587c, topicName=逆转录病毒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f67438, createdName=xiaogang317, createdTime=Tue Mar 20 17:01:00 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1688285, encodeId=3d091688285b5, content=<a href='/topic/show?id=e1875580689' target=_blank style='color:#2F92EE;'>#抗逆转录病毒#</a>, beContent=null, objectType=article, channel=null, level=null, 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createdBy=bed5446, createdName=limedical1974, createdTime=Wed Mar 07 10:01:00 CST 2018, time=2018-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206654, encodeId=800a206654c4, content=学习了,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLC1BMzZWdMSPQWuib6BtQGicK8ygGBM6YakpfkRc67soFSuKbZr86enL1KggQZEZbgWSeicJibafmYfQ3AibicIHMwwicmDShfRFvvI38/0, createdBy=272a110164, createdName=laoli, createdTime=Mon Jun 05 06:42:05 CST 2017, time=2017-06-05, status=1, ipAttribution=)]
    2018-02-14 mjldent
  5. 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  6. 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  7. 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href='/topic/show?id=09d594e5610' target=_blank style='color:#2F92EE;'>#逆转录#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94756, encryptionId=09d594e5610, topicName=逆转录)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ac59108, createdName=hxj0117, createdTime=Fri Oct 20 12:01:00 CST 2017, time=2017-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2053259, encodeId=7882205325925, content=<a href='/topic/show?id=6d7796998e0' target=_blank style='color:#2F92EE;'>#长期影响#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96998, encryptionId=6d7796998e0, topicName=长期影响)], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/cc81592b507031e3cfd8d4c57911d98b/62c22832a9474aea1ca90ca058aebc03.jpg, createdBy=bed5446, createdName=limedical1974, createdTime=Wed Mar 07 10:01:00 CST 2018, time=2018-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206654, encodeId=800a206654c4, content=学习了,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLC1BMzZWdMSPQWuib6BtQGicK8ygGBM6YakpfkRc67soFSuKbZr86enL1KggQZEZbgWSeicJibafmYfQ3AibicIHMwwicmDShfRFvvI38/0, createdBy=272a110164, createdName=laoli, createdTime=Mon Jun 05 06:42:05 CST 2017, time=2017-06-05, status=1, ipAttribution=)]
    2017-08-21 smallant2015
  8. [GetPortalCommentsPageByObjectIdResponse(id=1916794, encodeId=f11a1916e94fa, content=<a href='/topic/show?id=f24198994a6' target=_blank style='color:#2F92EE;'>#青年人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98994, encryptionId=f24198994a6, topicName=青年人)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=284b425, createdName=zll0625, createdTime=Wed Nov 15 20:01:00 CST 2017, time=2017-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1850611, encodeId=3a8c185061117, content=<a href='/topic/show?id=46c682469e4' target=_blank style='color:#2F92EE;'>#肾功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82469, encryptionId=46c682469e4, topicName=肾功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28d456, 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topicName=转录)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58df35929710, createdName=mjldent, createdTime=Wed Feb 14 21:01:00 CST 2018, time=2018-02-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2053182, encodeId=4dd6205318227, content=<a href='/topic/show?id=623294e587c' target=_blank style='color:#2F92EE;'>#逆转录病毒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94758, encryptionId=623294e587c, topicName=逆转录病毒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f67438, createdName=xiaogang317, createdTime=Tue Mar 20 17:01:00 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1688285, encodeId=3d091688285b5, content=<a href='/topic/show?id=e1875580689' target=_blank style='color:#2F92EE;'>#抗逆转录病毒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55806, encryptionId=e1875580689, topicName=抗逆转录病毒)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=05c928519131, createdName=ms1292405679162969, createdTime=Fri Oct 20 19:01:00 CST 2017, time=2017-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1777588, encodeId=65251e7758899, content=<a href='/topic/show?id=eb9610265ed' target=_blank style='color:#2F92EE;'>#JCEM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10265, encryptionId=eb9610265ed, topicName=JCEM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2a4439169927, createdName=smallant2015, createdTime=Mon Aug 21 19:01:00 CST 2017, time=2017-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1926842, encodeId=bf76192684255, content=<a href='/topic/show?id=09d594e5610' target=_blank style='color:#2F92EE;'>#逆转录#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94756, encryptionId=09d594e5610, topicName=逆转录)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ac59108, createdName=hxj0117, createdTime=Fri Oct 20 12:01:00 CST 2017, time=2017-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2053259, encodeId=7882205325925, content=<a href='/topic/show?id=6d7796998e0' target=_blank style='color:#2F92EE;'>#长期影响#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96998, encryptionId=6d7796998e0, topicName=长期影响)], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/cc81592b507031e3cfd8d4c57911d98b/62c22832a9474aea1ca90ca058aebc03.jpg, createdBy=bed5446, createdName=limedical1974, createdTime=Wed Mar 07 10:01:00 CST 2018, time=2018-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206654, encodeId=800a206654c4, content=学习了,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLC1BMzZWdMSPQWuib6BtQGicK8ygGBM6YakpfkRc67soFSuKbZr86enL1KggQZEZbgWSeicJibafmYfQ3AibicIHMwwicmDShfRFvvI38/0, createdBy=272a110164, createdName=laoli, createdTime=Mon Jun 05 06:42:05 CST 2017, time=2017-06-05, status=1, ipAttribution=)]
    2017-10-20 hxj0117
  9. [GetPortalCommentsPageByObjectIdResponse(id=1916794, encodeId=f11a1916e94fa, content=<a href='/topic/show?id=f24198994a6' target=_blank style='color:#2F92EE;'>#青年人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98994, encryptionId=f24198994a6, topicName=青年人)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=284b425, createdName=zll0625, createdTime=Wed Nov 15 20:01:00 CST 2017, time=2017-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1850611, encodeId=3a8c185061117, content=<a href='/topic/show?id=46c682469e4' target=_blank style='color:#2F92EE;'>#肾功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82469, encryptionId=46c682469e4, topicName=肾功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28d456, 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href='/topic/show?id=09d594e5610' target=_blank style='color:#2F92EE;'>#逆转录#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94756, encryptionId=09d594e5610, topicName=逆转录)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ac59108, createdName=hxj0117, createdTime=Fri Oct 20 12:01:00 CST 2017, time=2017-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2053259, encodeId=7882205325925, content=<a href='/topic/show?id=6d7796998e0' target=_blank style='color:#2F92EE;'>#长期影响#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96998, encryptionId=6d7796998e0, topicName=长期影响)], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/cc81592b507031e3cfd8d4c57911d98b/62c22832a9474aea1ca90ca058aebc03.jpg, createdBy=bed5446, createdName=limedical1974, createdTime=Wed Mar 07 10:01:00 CST 2018, time=2018-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206654, encodeId=800a206654c4, content=学习了,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLC1BMzZWdMSPQWuib6BtQGicK8ygGBM6YakpfkRc67soFSuKbZr86enL1KggQZEZbgWSeicJibafmYfQ3AibicIHMwwicmDShfRFvvI38/0, createdBy=272a110164, createdName=laoli, createdTime=Mon Jun 05 06:42:05 CST 2017, time=2017-06-05, status=1, ipAttribution=)]
  10. 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createdBy=bed5446, createdName=limedical1974, createdTime=Wed Mar 07 10:01:00 CST 2018, time=2018-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206654, encodeId=800a206654c4, content=学习了,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLC1BMzZWdMSPQWuib6BtQGicK8ygGBM6YakpfkRc67soFSuKbZr86enL1KggQZEZbgWSeicJibafmYfQ3AibicIHMwwicmDShfRFvvI38/0, createdBy=272a110164, createdName=laoli, createdTime=Mon Jun 05 06:42:05 CST 2017, time=2017-06-05, status=1, ipAttribution=)]
    2017-06-05 laoli

    学习了,谢谢分享!

    0

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