[Metabolic disorders and lipodystrophy. Adverse effects of antiretroviral therapy]

Lipodystrophy resp. lipoatrophy and metabolic disorders under antiretroviral therapy are mainly imputed to protease inhibitors. Nucleoside-analogues are suspected to cause lactatea-cidosis as well. The treatment does not pursue standardized concepts. The lipodystrophic alterations which are not endangering the patient but are often cumbersome for him, can be met by PI-saving therapy in a few cases. Against hyperlipidemia cholesterol-synthesis inhibitors are currently debated. Diabetes-therapy follows the conventional concepts. In case of lactate-acidosis antiretroviral therapy must be discontinued temporarily.