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Related Experiment Videos

Insulin and carbohydrate dysregulation.

Marie C Gelato1

  • 1Department of Medicine, University Hospital at Stony Brook, Stony Brook, New York 11794-8154, USA. Marie.Gelato@stonybrook.edu

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|March 26, 2003
PubMed
Summary

Highly active antiretroviral therapy (HAART) for HIV can cause body composition and metabolic issues, including insulin resistance and diabetes. Protease inhibitor-containing regimens are particularly linked to these adverse effects.

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Area of Science:

  • Biochemistry
  • Endocrinology
  • Virology

Background:

  • Highly active antiretroviral therapy (HAART) is crucial for managing human immunodeficiency virus (HIV).
  • Patients on HAART can develop metabolic abnormalities like dyslipidemia and abnormal carbohydrate metabolism.
  • Body composition changes, including visceral adiposity and peripheral fat wasting, are also observed.

Purpose of the Study:

  • To discuss the known information regarding insulin and carbohydrate dysregulation in patients receiving HAART.
  • To explore the potential link between body composition changes and metabolic abnormalities in HIV patients on HAART.
  • To highlight the association between specific HAART regimens, particularly those including protease inhibitors (PIs), and adverse metabolic outcomes.

Main Methods:

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  • Review of existing literature on HAART, metabolic syndrome, and body composition changes in HIV patients.
  • Analysis of data linking specific antiretroviral drug classes, such as protease inhibitors, to metabolic complications.
  • Discussion of the pathophysiology of insulin resistance and diabetes mellitus in the context of HIV treatment.

    • Main Results:

    • HAART is associated with dyslipidemia (high triglycerides, low HDL cholesterol) and abnormal carbohydrate metabolism, ranging from insulin resistance to diabetes.
    • Protease inhibitor (PI)-containing HAART regimens show a higher incidence of insulin resistance (up to 90%) and diabetes mellitus (up to 40%).
    • The relationship between body composition changes (visceral fat increase, peripheral fat loss) and carbohydrate metabolism abnormalities remains unclear.

    Conclusions:

    • Metabolic and body composition abnormalities are significant concerns for patients on HAART.
    • PI-based HAART regimens are strongly associated with increased risk of insulin resistance and diabetes.
    • Further research is needed to elucidate the exact mechanisms underlying these HAART-induced metabolic and compositional changes.