title: [Metabolic and cardiovascular effects of combined antiretroviral therapy in patients with HIV infection. Systematic review of literature].
abstract: In HIV infected patients an increased incidence of cardiac events has been reported since the introduction of highly active antiretroviral therapy (HAART). Antiretroviral drugs' regimens are, in fact, associated with several metabolic side effects, such as dyslipidemia, impaired glucose metabolism and abnormal body fat distribution, that increase cardiovascular risk of HIV subjects. In addition, HIV infection itself, the chronic inflammatory status and the frequent presence in this population of traditional risk factors contribute to an higher incidence of cardio and cerebrovascular events. In last years several studies showed the occurrence of carotid vascular impairment in patients treated with protease inhibitors (PI). Similarly the DAD Study reported an increase of 26% of the risk of myocardial infarction in patients on HAART and that this risk was independently associated with longer exposure to PI, after multivariate adjustments. A correct evaluation of the metabolic status before starting HAART and an adequate control of drugs-related metabolic abnormalities may reduce the incidence of cardiac events and still improve HIV patients prognosis. This review will focus on the metabolic effects of antiretroviral drugs and on the contribution of combination antiretroviral therapy on cardiovascular risk.
authors.affiliation: Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Università Federico II, Napoli, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Casaretti
authors.forename: Stefania
authors.initials: S
authors.lastname: Paolillo
authors.forename: Roberto
authors.initials: R
authors.lastname: Formisano
authors.forename: Ada
authors.initials: A
authors.lastname: Bologna
authors.forename: Giacomo
authors.initials: G
authors.lastname: Mattiello
authors.forename: Sirio
authors.initials: S
authors.lastname: Conte
authors.forename: Laura
authors.initials: L
authors.lastname: Petraglia
authors.forename: Francesco
authors.initials: F
authors.lastname: Lo ludice
authors.forename: Irma
authors.initials: I
authors.lastname: Fabiani
authors.forename: Anna Paola
authors.initials: AP
authors.lastname: Cirillo
authors.forename: Alice
authors.initials: A
authors.lastname: Vitagliano
authors.forename: Francesco
authors.initials: F
authors.lastname: Gambardella
authors.forename: Giuseppe Luca
authors.initials: GL
authors.lastname: della Ratta
authors.forename: Pasquale Perrone
authors.initials: PP
authors.lastname: Filardi
mesh_terms: D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000821:virology; D002561:Cerebrovascular Disorders / Q000139:chemically induced / Q000821:virology; D050171:Dyslipidemias / Q000139:chemically induced* / Q000453:epidemiology; D019317:Evidence-Based Medicine; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D024821:Metabolic Syndrome / Q000139:chemically induced* / Q000453:epidemiology / Q000821:virology; D011480:Protease Inhibitors / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D011480:Protease Inhibitors