Metabolic abnormalities in patients with HIV infection

I would like to focus on metabolic alterations, and the problems associated with them such as dyslipidemia, insulin resistance, fat loss or lipoatrophy, and fat accumulation. There are also conditions such as bone disease, hyperlactatemia, and other complications. It is not clear whether these problems are just toxicities of the drugs, how they are related to HIV independent of treatments, and whether they belong in discussions of metabolic complications. For the purposes of this discussion, I would like to consider each problem individually while also recognizing overlapping elements in an effort to understand complex etiologic interrelationships.