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Updated: Aug 12, 2026

Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
05:53

Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty

Published on: July 24, 2013

Cardiovascular risk factors in HIV-infected patients

Andrew Carr1

  • 1HIV Immunology and Infectious Diseases Clinical Services Unit, St Vincent's Hospital, Sydney, 2010, Australia. acarr@stvincents.com.au

Journal of Acquired Immune Deficiency Syndromes (1999)
|October 18, 2003
PubMed

Insights

Highly active antiretroviral therapy (HAART) can cause dyslipidemia and insulin resistance, increasing cardiovascular disease (CVD) risk. Treatment strategies for these conditions are unclear, especially for patients with lower HIV progression risk.

Area of Science:

  • Internal Medicine
  • Cardiology
  • Infectious Diseases

Background:

  • Highly active antiretroviral therapy (HAART) is associated with persistent dyslipidemia and insulin resistance.
  • These metabolic changes are suspected to increase the incidence of cardiovascular disease (CVD) in patients on HAART.
  • Both protease inhibitors (PIs) and nucleoside analog reverse transcriptase inhibitors (NRTIs) contribute to these adverse effects.

Purpose of the Study:

  • To review the relationship between HAART, dyslipidemia, insulin resistance, and cardiovascular disease (CVD).
  • To evaluate the current treatment strategies for managing dyslipidemia and insulin resistance in patients on HAART.
  • To clarify the safety, efficacy, and optimal roles of various treatment interventions.

Main Methods:

  • Review of existing literature on HAART, metabolic complications, and CVD.
  • Analysis of studies investigating the impact of PIs and NRTIs on lipid and glucose metabolism.
  • Evaluation of treatment strategies including lifestyle changes, pharmacotherapy, and antiretroviral regimen modification.

Main Results:

  • HAART-induced dyslipidemia and insulin resistance are linked to increased CVD risk.
  • PIs have direct metabolic effects, while both PIs and NRTIs contribute indirectly via lipodystrophy.
  • Previous studies on CVD incidence and HAART lacked prospective design and adequate power.
  • The relative safety and efficacy of management strategies for dyslipidemia and insulin resistance remain unclear.

Conclusions:

  • Management of dyslipidemia and insulin resistance is recommended for HAART patients, particularly those with multiple CVD risk factors.
  • Treatment benefits are greatest in individuals with higher perceived CVD risk and lower risk of HIV disease progression.
  • Further prospective studies are needed to establish definitive treatment guidelines and assess long-term outcomes.

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