HIV therapy, metabolic syndrome, and cardiovascular risk.
People with HIV infection have metabolic abnormalities that resemble metabolic syndrome (hypertriglyceridemia, low high-density lipoprotein cholesterol, and insulin resistance), which is known to predict increased risk of cardiovascular disease (CVD). However, there is not one underlying cause for these abnormalities and they are not linked to each other. Rather, individual abnormalities can be affected by the host response to HIV itself, specific HIV drugs, classes of HIV drugs, HIV-associated lipoatrophy, or restoration to health. Furthermore, one component of metabolic syndrome, increased waist circumference, occurs less frequently in HIV infection. Thus, HIV infection supports the concept that metabolic syndrome does not represent a syndrome based on a common underlying pathophysiology. As might be predicted from these findings, the prevalence of CVD is higher in people with HIV infection. It remains to be determined whether CVD rates in HIV infection are higher than might be predicted from traditional risk factors, including smoking.
Pao
Vivian
V
Department of Veterans Affairs Medical Center, Metabolism Section (Box 111F), 4150 Clement Street, San Francisco, CA 94121, USA.
Lee
Grace A
GA
Grunfeld
Carl
C
D000273:Adipose Tissue / Q000187:drug effects; D050197:Atherosclerosis / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000503:physiopathology; D008076:Cholesterol, HDL / Q000097:blood; D015897:Comorbidity; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D017320:HIV Protease Inhibitors / Q000009:adverse effects; D039682:HIV-Associated Lipodystrophy Syndrome / Q000139:chemically induced; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D015228:Hypertriglyceridemia / Q000139:chemically induced / Q000453:epidemiology; D019469:Indinavir / Q000494:pharmacology / Q000627:therapeutic use; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence; D012307:Risk Factors; D019438:Ritonavir / Q000009:adverse effects; D009626:Terminology as Topic
D008076:Cholesterol, HDL; D017320:HIV Protease Inhibitors; D019469:Indinavir; D019438:Ritonavir