Metabolic complications of antiretroviral therapy

HIV-infected patients receiving long-term antiretroviral treatment experience a number of metabolic abnormalities, including lipid abnormalities, dysregulation of glucose metabolism, body-fat redistribution, mitochondrial abnormalities, and bone abnormalities, as well as the sequelae of these disorders. These complications can be severe and life threatening, disrupt adherence to antiretroviral therapy, limit options in therapy, and profoundly affect quality of life. Risk for such complications should be considered in selection of antiretroviral therapy, and patients should be monitored for the occurrence of abnormalities and changes in risk factors. This article summarizes a presentation by Donna E. Sweet, MD, on the metabolic complications of long-term antiretroviral therapy at the IAS-USA course in New York in March 2005.