分析成年愛滋病毒感染者基因多型性及心血管疾病風險之研究

研究背景：因為醫療水準的提升及愛滋照護的經驗的累積和抗愛滋病毒藥物的進化，愛滋病毒感染者的存活期已經和一般大眾相當接近。但是因為愛滋病毒本身就會刺激血管發炎及造成血脂異常，所以心血管疾病風險是當前重要課題。而且代表感染者身體現況的愛滋病毒量和CD4淋巴球數目也尤為重要。研究方法：此研究是縱向性的世代研究。我們分析了七種和心血管疾病風險因子有關的單核苷酸多型性(Single Nucleotide Polymorphism, SNPs)，進而找出和心血管風險因子相關的基因多型性，希望找出愛滋病毒感染病人的心血管疾病風險相關之預測因子。研究結果：CYP2B6 rs2279345 基因多型性中，帶有CC基因型，不管是身體質量指數( Body Mass Index, BMI)或是體重增加的數值，都比其他兩基因型多(p=0.0283 體重增加; p=0.0238 BMI增加)。依次是TC基因型，增加最少的是TT基因型。和愛滋病毒染者息息相關的病毒量和CD4淋巴球方面：CYP2A6 rs28399433 以AA基因型為基準值相比，帶有CA基因型和CC基因型都比AA基因型的人，CD4淋巴球數較低 (p=0.0159 CA versus AA ; p=0.0431CC versus AA)。APOE rs7412 TC基因型比CC基因型有較容易控制病毒量到測不到的趨勢，校正後勝算比0.53 (0.27-1.04)，且隨著時間增加rs7412 TC基因型對病毒量也有相似的影響(p=0.0615)，因為兩個數值都在臨界值邊緣，所以需要更多證據來證實。結論：愛滋病毒感染者，比較CYP2B6 rs2279345 基因多型性中，如果帶有CC基因型，需要加強控制身體質量指數或是體重增加的數值以免因肥胖造成心血管風險比率升高。CYP2A6 rs28399433 帶有CA基因型和CC基因型應密切注意其CD4淋巴球數數值，以免過低而造成伺機性感染。

關鍵字

愛滋病；愛滋病毒感染；心血管疾病風險；單核苷酸多形性；身體質量指數

並列摘要

Background: On account of the accumulation of experience in AIDS care and the evolution of antiretrovial therapy, the life expectancy of HIV-infected people has been nearly close to general population. Because of the HIV virus itself stimulates blood vessel inflammation and the formation of abnormal blood lipids, therefore, the risk of cardiovascular disease in HIV-infected person is became an important issue currently. The amount of HIV and CD4 lymphocytes, which represent the physical condition of the infected person, are also particularly important. Methods: This study is a longitudinal cohort study. We have analyzed seven single nucleotide polymorphisms (SNPs) that related with cardiovascular risk factors by real-time PCR, and then determined potential genetic polymorphisms that related to cardiovascular risk factors, hoping to find out genetic predictors related to the risk of cardiovascular disease for HIV-infected individuals. Results: In the CYP2B6 rs2279345 genotypes (CC, TC and TT), if it has the CC genotype, both body mass index (BMI) and the value of weight gain, are higher than the other two groups that is followed by TC genotype, with the least increase is TT genotype (p=0.0283 weight gain; p=0.0238 BMI increase). In the CYP2A6 rs28399433 SNP analysis, compared with the AA genotype as the benchmark value, people with CA genotype and CC genotype have lower CD4 lymphocytes numbers than those with AA genotype (p =0.0159 CA versus AA; p=0.0431 CC versus AA). The APOE rs7412 TC genotype is associated with better control of the virus replication than the CC genotype. The odds ratio after correction is 0.53 (0.27-1.04). Furthermore, the effect of rs7412 TC genotype on the reduced virus load (p=0.0615) also associated with time increases, both two values are on the edge of the critical value, therefore, more evidence is needed to have a conclusion. Conclusion: Among CYP2B6 rs2279345 polymorphism, if the CC genotype is present, it is necessary to strengthen the control of the body mass index or the value of weight gain to avoid an increase in the cardiovascular risk ratio due to obesity in HIV-infected persons. CYP2A6 rs28399433 with CA genotype and CC genotype should pay more attention to the CD4 value of patient to prevent opportunistic infection.

並列關鍵字

HIV ； AIDS ； Antiretroviral therapy ； SNPs

參考文獻

1. cdc.gov/hiv/basics/whatishiv.html Centers for Disease Control and Prevention US

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2. https://www.who.int/health-topics/hiv-aids#tab=tab_1 World Health Organization

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3. https://www.unaids.org/en

Google Scholar

4. https://www.cdc.gov.tw/Disease/SubIndex/3s96eguiLtdGQtgNv7Rk1g

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5. Charlotte Lewden et al. Causes of death among human immunodeficiency virus (HIV)-infected adults in the era of potent antiretroviral therapy: emerging role of hepatitis and cancers, persistent role of AIDS International Journal of Epidemiology, Volume 34, Issue 1, February 2005, Pages 121–130

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分析成年愛滋病毒感染者基因多型性及心血管疾病風險之研究

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