Toxic metabolic syndrome associated with HAART.
Acquired fat redistribution, that is, peripheral fat loss often accompanied by central fat accumulation in patients with HIV infection is the most common form of lipodystrophy in man. Approximately 30 - 50% of HIV-infected individuals after > or = 12 months on highly active antiretroviral therapy (HAART) may encounter the HIV-associated lipodystrophy syndrome (HALS), which attenuates patient compliance to this treatment. HALS is characterised by impaired glucose and lipid metabolism and other risk factors for cardiovascular disease. This review depicts the metabolic abnormalities associated with HAART by describing the key cell and organ systems that are involved, emphasising the role of insulin resistance. An opinion on the remedies available to treat the metabolic abnormalities and phenotype of HALS is provided.
Haugaard
Steen B
SB
Clinical Research Unit, Department of Endocrinology and Internal Medicine, Hvidovre University Hospital, DK 2650 Hvidovre, Copenhagen, Denmark. sbhau@dadlnet.dk
D052242:Adiponectin / Q000378:metabolism; D000273:Adipose Tissue / Q000187:drug effects* / Q000378:metabolism; D000818:Animals; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D001851:Bone Diseases, Metabolic / Q000209:etiology; D050171:Dyslipidemias / Q000188:drug therapy / Q000209:etiology* / Q000378:metabolism; D013007:Growth Hormone-Releasing Hormone / Q000494:pharmacology / Q000627:therapeutic use; D015658:HIV Infections / Q000188:drug therapy* / Q000378:metabolism; D039682:HIV-Associated Lipodystrophy Syndrome / Q000188:drug therapy / Q000209:etiology* / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D019344:Lactic Acid / Q000378:metabolism; D008928:Mitochondria / Q000187:drug effects / Q000378:metabolism; D009203:Myocardial Infarction / Q000209:etiology; D016032:Randomized Controlled Trials as Topic; D051780:Sterol Regulatory Element Binding Protein 1 / Q000378:metabolism; D014280:Triglycerides / Q000378:metabolism
C499918:ADIPOQ protein, human; D052242:Adiponectin; D007004:Hypoglycemic Agents; D007328:Insulin; C497387:SREBF1 protein, human; D051780:Sterol Regulatory Element Binding Protein 1; D014280:Triglycerides; D019344:Lactic Acid; D013007:Growth Hormone-Releasing Hormone