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EVALUACION DEL RIESGO CARDIOVASCULAR EN PACIENTES HIV POSITIVOS

(especial para SIIC © Derechos reservados)
La enfermedad cardiovascular puede constituirse en una importante complicación de la infección por VIH a mediano y largo plazo.
iriberri9.jpg Autor:
Guillermo enrique Iriberri
Columnista Experto de SIIC

Institución:
Hospital Francisco Javier Muñiz, Unidad de Guardia del Departamento de Urgencias

Artículos publicados por Guillermo enrique Iriberri
Recepción del artículo
12 de Junio, 2006 		Aprobación
26 de Junio, 2006
Primera edición
15 de Septiembre, 2006 		Segunda edición, ampliada y corregida
7 de Junio, 2021

EVALUACION DEL RIESGO CARDIOVASCULAR EN PACIENTES HIV POSITIVOS

Resumen
La terapéutica antirretroviral de gran actividad (TARGA) ha permitido una disminución de la morbimortalidad a corto plazo en aquellos pacientes infectados por VIH. Sin embargo, se ha podido comprobar en ellos la presencia de distintas alteraciones metabólicas, en particular, la de dislipemia. Esto lleva a suponer que la enfermedad cardiovascular puede constituirse en una importante complicación de la infección por VIH a mediano y largo plazo. En esta revisión se pondrá de manifiesto ese riesgo y se darán las bases para un adecuado manejo de la dislipemia, se analizan las mejores estrategias terapéuticas en cuanto a cambios en el estilo de vida, al tratamiento con hipolipemiantes y al ajuste en la TARGA. Se recomendará no realizar ningún cambio en el régimen antirretroviral que pueda comprometer la estabilidad virológica o inmunológica del paciente ya que, el riesgo absoluto de muerte asociado al sida que está fuera de control virológico, es marcadamente mayor que el asociado a la enfermedad cardiovascular. Se hará constar, además, la necesidad de estudios prospectivos que evalúen los efectos del tratamiento de los factores de riesgo cardiovascular que se desarrollen mientras el paciente se halla bajo TARGA y del efecto que producirán los cambios en los regímenes antirretrovirales.

Palabras clave
Riesgo cardiovascular, TARGA, VIH, sida


Artículo completo
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CARDIOVASCULAR RISK IN PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION

Abstract
Highly active antiretroviral therapy (HAART) has been associated with a decrease in the short-term morbidity and mortality in patients with HIV infection. Nevertheless, several metabolic changes, specifically dyslipidemia, are common in them. The preceding leads to a concern that cardiovascular disease may become an important complication of HIV infection in the mid and long-term. This review highlights the risk and gives the basis for the management of dyslipidemia, analyzing the best therapeutic strategy in lifestyle changes, lipid-lowering therapy and HAART switching. The most important recommendation is not to carry out any change in the antiretroviral therapy that could put virologic and immunologic stability at risk, because, absolute death rates from AIDS out of viremic control are higher than rates for cardiovascular disease. Prospective studies evaluating the effects of treatment of cardiovascular risk factors that develop while in HAART and the effects of changes in antiretroviral regimens are needed.

Key words
Cardiovascular risk, HAART, AIDS, HIV

Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Infectología
Relacionadas: Bioquímica, Cardiología, Diagnóstico por Laboratorio, Epidemiología, Medicina Interna, Pediatría



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Enviar correspondencia a:
Guillermo E. Iriberri, Unidad de Guardia del Departamento de Urgencias, Hospital Francisco Javier Muñiz, Av. Federico Lacroze 2277 4º piso B, Buenos Aires, Argentina
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