Pathogenesis of HIV-Associated Metabolic Syndrome and Clinical Management Recommendations

The phenomenon of metabolic syndrome in patients with HIV infection has attracted increasing attention. HIV infection increases the risk of metabolic complications, including cardiovascular diseases and diabetes. Meanwhile, the potential metabolic side effects of antiretroviral therapy in HIV patients have emerged as a new clinical challenge. This study delineates the potential mechanisms underlying HIV-associated metabolic syndrome, encompassing inflammation and immune activation, glucose and lipid metabolism disorders, mitochondrial and vascular endothelial abnormalities, gut microbiota dysbiosis, epigenetic alterations, and the application of certain antiretroviral drugs. These mechanisms interact and exacerbate each other, with inflammation and immune activation playing a pivotal role. This study also discusses the potential associations between HIV infection and various metabolic diseases, and consolidates clinical management recommendations for HIV-associated metabolic syndrome, including diet, exercise, and lipid, glucose, and blood pressure management.