title: Management of the metabolic effects of HIV and HIV drugs.
abstract: Morphologic and metabolic abnormalities, including subcutaneous adipose tissue wasting, central adipose tissue accumulation, dyslipidemia and disorders of glucose metabolism are common among HIV-infected patients receiving highly active antiretroviral therapy (HAART) and contribute to the risk of cardiovascular disease in this population. The pathogenesis of these disorders is due to complicated interactions between effects of chronic HIV infection, HAART medications and patient factors, including genetic susceptibility. HAART has transformed HIV into a chronic condition for many patients and as a result the majority of HIV-infected patients in many areas of the developed world will soon be aged ≥50 years. Given that metabolic and cardiovascular diseases increase with aging, knowledge of the optimal management of these conditions is essential for practitioners caring for HIV-infected patients, including endocrine subspecialists. This Review highlights the clinical management of these disorders, focusing on the latest evidence regarding the efficacy of treatment strategies, newly available medications and potential interactions between HAART medications and medications used to treat metabolic disorders.
authors.affiliation: Division of Endocrinology and Metabolism, Johns Hopkins University, 1830 East Monument Street, Baltimore, MD 21287, USA. tbrown27@jhmi.edu
authors.forename: Todd T
authors.initials: TT
authors.lastname: Brown
authors.forename: Marshall J
authors.initials: MJ
authors.lastname: Glesby
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects / Q000378:metabolism; D019380:Anti-HIV Agents / Q000009:adverse effects*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000209:etiology; D003920:Diabetes Mellitus / Q000139:chemically induced / Q000209:etiology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000139:chemically induced / Q000209:etiology; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008659:Metabolic Diseases / Q000139:chemically induced* / Q000209:etiology* / Q000628:therapy*
chemical_list: D019380:Anti-HIV Agents