[Changes in lipid tissue redistribution and metabolic disorders in HIV positive patients treated with protease...

Area of Science:

• Infectious Diseases
• Pharmacology
• Immunology

Context:

• Highly active antiretroviral therapy (HAART) significantly reduced AIDS mortality since 1996.
• Protease inhibitors (PI) were a cornerstone of early HAART regimens.
• Lipodystrophy emerged as a major adverse effect of PI therapy.

Purpose:

• To review the clinical aspects, pathogenesis, treatment, and consequences of lipodystrophy associated with PI therapy.
• To discuss the implications of switching from PI-based HAART to PI-sparing regimens.
• To provide an overview of current knowledge on this significant complication of HIV treatment.

Summary:

• Introduction of protease inhibitors (PI) in 1996 dramatically decreased AIDS mortality.
• Lipodystrophy, a severe side effect of PI, involves lipid redistribution and negatively impacts HIV-positive patients on HAART.
• Patients often switch from PI to non-nucleoside reverse transcriptase inhibitors (NNRTI) and nucleoside reverse transcriptase inhibitors (NRTI) to avoid lipodystrophy, potentially limiting future treatment choices.

Impact:

• Lipodystrophy complicates HIV management and worsens prognosis for patients on HAART.
• Therapeutic shifts away from PIs due to lipodystrophy may restrict long-term treatment options.
• Understanding lipodystrophy's mechanisms and management is crucial for optimizing HIV care.