title: Approach to dyslipidemia, lipodystrophy, and cardiovascular risk in patients with HIV infection.
abstract: There is a significant prevalence (20%-80% depending on the population and the study) of lipid disorders and other cardiovascular risk factors in people living with HIV infection. This review focuses on HIV and HIV treatment-associated metabolic and cardiovascular concerns, including dyslipidemias, lipodystrophy syndromes, endothelial dysfunctions, and associated metabolic events such as insulin resistance. Emerging hypotheses of the underlying pathophysiology of these issues, with impact on selection of specific antiretroviral treatment (ART) strategies, therapy, and preventive approaches to decreasing cardiovascular risk and other problems associated with these syndromes are discussed. Screening for cardiovascular risk as part of the decision of starting antiretroviral therapy, and during care of patients with HIV regardless of ART therapy status, is suggested with particular areas of focus. Statins, other hyperlipidemic therapies, treatment for specific problems arising due to lipodystrophy, and implications on ART selection to avoid drug interactions and adverse effects are also discussed.
authors.affiliation: Touro University College of Osteopathic Medicine, 1310 Club Drive, Vallejo, CA 94592, USA. greg.troll@tu.edu
authors.forename: J Gregory
authors.initials: JG
authors.lastname: Troll
mesh_terms: D044966:Anti-Retroviral Agents / Q000494:pharmacology; D002318:Cardiovascular Diseases / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology / Q000517:prevention & control*; D004347:Drug Interactions; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D006678:HIV; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology; D007333:Insulin Resistance; D050356:Lipid Metabolism / Q000187:drug effects; D008060:Lipodystrophy / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D008134:Long-Term Care; D012307:Risk Factors; D055502:Secondary Prevention
chemical_list: D044966:Anti-Retroviral Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors