[Lipodystrophy and lipid metabolism alterations in HIV-infected patients receiving highly active antiretroviral therapy (HAART)].
A wide range of morphologic alterations and lipid metabolism abnormalities have been recently described in HIV-infected patients receiving a protease inhibitor-based highly active antiretroviral therapy. The hyperlipidaemia may involve up to 70-80% of HIV-positive subjects treated with a protease inhibitor-containing regimen, and it is frequently (but not always) associated with the fat redistribution syndrome or lipodystrophy. The potential clinico-pathological consequences of HIV-associated hyperlipidaemia are not completely known, but several anecdotal observations reported an increased risk of prematury coronary artery diseases in young HIV-positive individuals receiving protease inhibitors, besides peripheral atherosclerosis and acute pancreatitis. A hypolipidaemic diet and regular physical exercise may act favourably on dyslipidaemia, but pharmacological therapy becomes necessary when hyperlipidaemia is severe or pesists for a long time. The choice of hypolipidaemic drugs is problematic because of potential pharmacological interactions with antiretroviral compounds and other antimicrobial agents, associated with an increased risk of toxicity and intolerance.
Calza
Leonardo
L
Sezione di Malattie Infettive, Dipartimento di Medicina Clinica Specialistica e Sperimentale, Università Alma Mater Studiorum, Policlinico S.Orsola, Bologna. malinf@med.unibo.it
Manfredi
Roberto
R
Chiodo
Francesco
F
D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000209:etiology* / Q000628:therapy; D006801:Humans; D006949:Hyperlipidemias / Q000209:etiology; D050356:Lipid Metabolism; D008659:Metabolic Diseases / Q000209:etiology* / Q000628:therapy