Avaliação do escore de cálcio e dislipidemia nos pacientes HIV positivos em uso de terapia antirretroviral

Abstract

Evaluation of artery calcium score and dyslipidemia in hiv infected patients on antiretroviral therapy. Background: Despite the advances of therapeutic knowledge with the development of the antirretroviral drugs and the use of Highly Active Antiretroviral therapy (HAART), there are still many difficulties with the management of HIV-infected patients. Continued use of antirretroviral drugs and chronic HIV infection are at increased risk of cardiovascular events, mainly due to the metabolic disorders these individuals develop. Therefore, diagnostic methods are crucial for early detection of cardiovascular disorders, especially in HIV-positive patients. In this regard, calcium score can be used as marker for presence and extension of atherosclerotic disease, permitting appropriate conduct in the prevention of cardiovascular diseases. Objectives: Demonstrate the association between calcium score and dyslipidemia in HIV-infected patients on antirretroviral therapy, correlating with the type and use duration of these drugs. Methods: Observational cross-section study to evaluate the changes in calcium score using coronary angiotomogrophy and correlation with lipid profile, by laboratory tests, with the registration of history data of the HIV infection and the use of antirretroviral therapy on selected population. Results: Of the 22 participants, seven (31.81%) had calcium score > 0. Of these, three (42.82%) used protease inhibitors (IP), six (85.75%) used non-nucleoside reverse transcriptase inhibitors (ITRNN) and all patients used nucleoside reverse transcriptase inhibitors (ITRN). Considering the patients who used IP, 60% had calcium score > 0. The mean duration of antiretroviral therapy was 8.64 years, with standard deviation of 5.81 on participants with calcium score > 0. The correlations between time in use of antiretroviral therapy, calcium score and lipid profile were not statistically significant. Discussion: We found a high prevalence of dyslipidemia among patients with HIV on antiretroviral therapy. Changes in calcium score and lipid profile agree with data of previous studies, showing na increased risk of cardiovascular disease in this group of patients. As alterações no escore de cálcio e do perfil lipídico, concordam com os dados de estudos anteriores, mostrando um maior risco de doenças cardiovasculares nesse grupo de pacientes. The continuation of this study, with a larger number of patients, is important for the internal and external validity of the results.