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Metabolic issues associated with protease inhibitors.

¹HIV Medicine, St. Stephens Centre, Chelsea and Westminster Hospital, London, United Kingdom. gm@moyleg.demon.co.uk

Journal of Acquired Immune Deficiency Syndromes (1999)

|May 26, 2007

Summary

HIV infection and antiretroviral therapy (ART) cause metabolic changes, increasing cardiovascular disease risk. Management involves lifestyle changes, medication, and careful drug selection to mitigate these risks.

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Area of Science:

Cardiology
Endocrinology
Infectious Diseases

Background:

HIV infection is associated with dyslipidemia, including low HDL and high triglycerides.
Antiretroviral therapy (ART) can exacerbate metabolic issues, increasing LDL, VLDL, triglycerides, and insulin resistance.
These metabolic changes elevate cardiovascular disease (CVD) risk in HIV-positive individuals.

Purpose of the Study:

To highlight the metabolic and cardiovascular risks associated with HIV and ART.
To emphasize the limitations of standard risk calculators in this population.
To discuss management strategies for metabolic risk in HIV-positive patients.

Main Methods:

Review of metabolic alterations in HIV infection.
Analysis of ART's impact on lipid profiles and insulin sensitivity.
Evaluation of cardiovascular risk assessment in the context of HIV.

Main Results:

HIV and ART contribute to dyslipidemia and insulin resistance.
Cardiovascular risk may be underestimated by conventional calculators.
Metabolic complications pose a significant CVD risk.

Conclusions:

HIV-positive individuals face elevated CVD risk due to metabolic changes from infection and ART.
Management requires lifestyle interventions, pharmacotherapy, and judicious ART selection.
Personalized strategies are crucial for mitigating metabolic and cardiovascular risks.