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Novel Approaches to Targeting Visceral and Hepatic Adiposities in HIV-Associated Lipodystrophy
1Department of Medicine, University of California, San Francisco, CA, 94143, USA. ptien@ucsf.edu.
Insights
Visceral and hepatic adiposities in HIV patients are linked to cardiovascular and liver issues. Effective combination antiretroviral therapy (ART) and aging contribute to these conditions, necessitating new therapeutic targets.
Area of Science:
- Internal Medicine
- Hepatology
- Infectious Diseases
Background:
- Visceral and hepatic adiposities are associated with cardiovascular and liver diseases, particularly concerning in HIV-infected individuals on combination antiretroviral therapy (ART).
- Historically, excess adiposity in HIV was attributed to specific antiretroviral drugs, termed "HIV-associated lipodystrophy syndrome."
- Current understanding suggests visceral adiposity results from effective ART, health recovery, and aging, with visceral adiposity being a risk factor for hepatic adiposity.
Purpose of the Study:
- To review the pathogenesis of visceral and hepatic adiposities in HIV-infected individuals.
- To summarize current therapeutic strategies for managing these conditions.
- To explore novel interventions for both HIV-infected and uninfected populations.
Main Methods:
- Literature review of recent studies on visceral and hepatic adiposities in HIV.
- Analysis of the pathogenesis, current treatments, and emerging interventions.
- Synthesis of findings related to HIV-associated metabolic complications.
Main Results:
- Visceral adiposity is increasingly recognized as a consequence of successful ART, improved health, and aging, rather than solely drug-induced toxicity.
- Visceral adiposity is a significant risk factor for the development of hepatic adiposity (fatty liver disease).
- Research into drug targets for non-alcoholic fatty liver disease is ongoing.
Conclusions:
- Effective ART, while crucial for managing HIV, contributes to visceral and hepatic adiposities alongside aging.
- Understanding the multifactorial etiology is key to developing targeted therapies.
- Further research is needed to identify effective interventions for reducing adiposity and associated liver disease in HIV-infected individuals.
Abstract:
Visceral and hepatic adiposities have been associated with both cardiovascular and liver disease and are of concern in HIV-infected persons in the modern era of combination antiretroviral therapy (ART). The development of therapeutic targets to reduce visceral and hepatic adiposities in HIV-infected persons has been slow, because of early reports that attributed the excess adiposity to specific antiretroviral drugs. Visceral adiposity was initially thought to occur as part of a protease inhibitor-induced "HIV-associated lipodystrophy syndrome." Subsequent studies show that visceral adiposity is likely a result of effective ART, recovery of health, and the normal aging process. Visceral adiposity is an established risk factor for hepatic adiposity. Identifying drug targets for non-alcoholic fatty liver disease is under active investigation. The present review summarizes the recent literature on the pathogenesis of visceral and hepatic adiposities in HIV-infected persons, current therapeutic strategies, and novel interventions in HIV-infected and uninfected persons.
