Body-fat abnormalities in patients with HIV: progress and challenges.
The introduction of newer antiretroviral drugs has provided greater levels of HIV suppression with fewer of the metabolic effects, lipoatrophy, and body habitus changes associated with earlier therapies. Previously classified under the collective term, lipodystrophy, lipoatrophy and body-fat changes are now known to occur independently in some HIV-infected patients, depending on the type and duration of antiretroviral therapy and a myriad of factors including HIV infection alone that contribute significantly to these changes. This article reviews the current scientific literature and recent clinical trial results that distinguish lipoatrophy or dyslipidemia pathophysiologically from body-fat changes seen as central and peripheral lipohypertrophy and fat redistribution, as well as the nature and extent of changes associated with HIV infection alone and newer antiretroviral therapies. This information may assist physicians in identifying individual risk factors and choosing the type of antiretroviral therapy that may minimize these changes without loss of virologic suppression.
Bedimo
Roger J
RJ
Internal Medicine, Infectious Diseases Section, VA North Texas Healthcare System, UT Southwestern Medical School, Dallas, Texas, USA. roger.bedimo@va.gov
D000273:Adipose Tissue / Q000002:abnormalities*; D019380:Anti-HIV Agents / Q000009:adverse effects; D015658:HIV Infections / Q000150:complications*; D017320:HIV Protease Inhibitors / Q000009:adverse effects; D015497:HIV-1 / Q000187:drug effects; D039682:HIV-Associated Lipodystrophy Syndrome / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects
D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors