Стратегии выбора антиретровирусной терапии у пациентов с ВИЧ-инфекцией и сердечно-сосудистыми заболеваниями
- Авторы: Шахгильдян В.И.1, Мацкеплишвили С.Т.2
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Учреждения:
- ФБУН «Центральный научно-исследовательский институт эпидемиологии» Роспотребнадзора
- ФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова»
- Выпуск: Том 97, № 4 (2025): Вопросы диагностики
- Страницы: 367-377
- Раздел: Обзоры
- URL: https://journals.rcsi.science/0040-3660/article/view/292182
- DOI: https://doi.org/10.26442/00403660.2025.04.203157
- ID: 292182
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Аннотация
Инфекция ВИЧ ассоциирована с повышенным риском сердечно-сосудистых заболеваний (ССЗ) и почечных осложнений. Сопутствующая патология постепенно становится одним из основных драйверов ранней смертности больных ВИЧ-инфекцией в Российской Федерации. С 2007 по 2022 г. частота летальных исходов у пациентов с ВИЧ-инфекцией от причин, не связанных с оппортунистическими инфекциями, увеличилась более чем в 2 раза. Лицам, живущим с ВИЧ, присущи все факторы сердечно-сосудистого риска, характерные для общей популяции, помимо этого особую роль играет нарушенная функция почек, вклад которой в риск ССЗ и их осложнений часто недооценивают. В публикации рассмотрены подходы к выбору современной антиретровирусной терапии у больных ВИЧ-инфекцией и сопутствующими ССЗ или высоким риском их развития. Проведен сравнительный анализ антиретровирусных препаратов, указанных зарубежными клиническими рекомендациями в качестве схем 1-й линии и доступных в России (схемы на основе долутегравира, биктегравира и доравирина). Детальное рассмотрение критериев выбора при определении схемы антиретровирусной терапии предполагает учет эффективности современных антиретровирусных препаратов при высокой вирусной нагрузке, низких показателях клеточного звена иммунитета, возможной низкой приверженности пациента лечению, профиля резистентности к препаратам, а также наличия таких сопутствующих заболеваний и состояний, как ССЗ, избыточная масса тела и патология почек. Кроме того, в статье затронуты вопросы междисциплинарного взаимодействия врачей-инфекционистов, терапевтов и кардиологов.
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Василий Иосифович Шахгильдян
ФБУН «Центральный научно-исследовательский институт эпидемиологии» Роспотребнадзора
Автор, ответственный за переписку.
Email: vishakh@yandex.ru
ORCID iD: 0000-0002-8686-0487
кандидат медицинских наук, старший научный сотрудник Специализированного научно-исследовательского отд. по профилактике и борьбе со СПИДом
Россия, МоскваСимон Теймуразович Мацкеплишвили
ФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова»
Email: vishakh@yandex.ru
ORCID iD: 0000-0002-5670-167X
чл.-кор. РАН, д-р мед. наук, профессор, рук. отд. кардиологии и сердечно-сосудистой хирургии Медицинского научно-образовательного института
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