BACKGROUND Given the known relationship between human immunodeficiency virus (HIV), antiretroviral therapies, and excess visceral adipose tissue (VAT), this review sought to characterize risk of negative health outcomes associated with excess VAT and increased waist circumference (WC) in people with HIV (PWH). METHODS Comprehensive targeted literature searches were conducted in Medline/Embase (27 June 2022), identifying peer-reviewed articles and conference abstracts reporting on cohorts of PWH. Screening was guided by PECOS (Population, Exposure, Comparator, Outcomes, Study design) criteria. From the included studies, outcomes of interest including mortality and morbidity risk by VAT area and WC were extracted, overall, and by sex, race/ethnicity, and duration of HIV. Relationships between outcome and exposure variables were summarized. RESULTS Thirty-five studies were included (sample size range: 31-1748 PWH). Twenty-five studies characterized the relationship between increased WC and negative health outcomes-cardiovascular disease (CVD), arteriosclerosis, hypertension, diabetes, hepatic fat and fibrosis, and cognitive impairment-among PWH. Fifteen studies reported on increased VAT and negative health outcomes: all-cause mortality, CVD, atherosclerosis, hepatic fat, and fibrosis. Importantly, there was a 2.1-times higher odds of 5-year all-cause mortality among PWH with the highest amount of VAT in the only study identified reporting on mortality. Among the studies characterizing the relationship between morbidity and VAT, for example, 1 found that, for each 10-cm2 increase in VAT, the risk of prevalent CVD increased by 1.05 (95% CI: 1.0-1.1) times. CONCLUSIONS WC may be a useful and cost-effective surrogate for visceral adiposity, which is an important marker of morbidity and mortality among PWH.

中文翻译：

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人类免疫缺陷病毒和中枢性或内脏肥胖患者的发病率和死亡风险：有针对性的文献综述。


背景 鉴于人类免疫缺陷病毒 （HIV）、抗逆转录病毒疗法和内脏脂肪组织过量 （VAT） 之间的已知关系，本综述试图描述 HIV 感染者 （PWH） 与过量 VAT 和腰围增加 （WC） 相关的负面健康结局风险。方法 在 Medline/Embase（2022 年 6 月 27 日）进行了全面的靶向文献检索，确定了报告 PWH 队列的同行评审文章和会议摘要。筛选以 PECOS（人群、暴露、比较、结果、研究设计）标准为指导。从纳入的研究中，按增值税地区和 WC 提取了感兴趣的结局，包括死亡率和发病率风险，总体上，以及按性别、种族/民族和 HIV 持续时间。总结了结局和暴露变量之间的关系。结果 共纳入 35 项研究 （样本量范围： 31-1748 PWH）。25 项研究描述了 WC 增加与 PWH 中负面健康结果之间的关系——心血管疾病 （CVD）、动脉硬化、高血压、糖尿病、肝脂肪和纤维化以及认知障碍。15 项研究报告了 VAT 增加和负面健康结局：全因死亡率、CVD、动脉粥样硬化、肝脂肪和纤维化。重要的是，PWH 的 5 年全因死亡率几率高出 2.1 倍，在唯一确定的死亡率报告中，增值税金额最高。例如，在描述发病率与增值税之间关系的研究中，1 发现，增值税每增加 10 cm2，患病率 CVD 的风险就会增加 1.05 倍（95% CI：1.0-1.1）倍。 结论 WC 可能是内脏肥胖的有用且具有成本效益的替代方法，内脏肥胖是 PWH 发病率和死亡率的重要标志。