Metabolic Complications of HIV and Antiretroviral Therapy: Dyslipidemia, Insulin Resistance, and Cardiovascular Disease

  • Authors: Judith S. Currier, MD, MSc; Risa Hoffman, MD, MPH (More Info)
  • Editors in Chief: Joseph J. Eron, Jr., MD; Daniel R. Kuritzkes, MD
  • Last Reviewed: 10/10/18 (What's New)

Introduction

  • Increased rates of dyslipidemia, abnormal glucose metabolism, and cardiovascular disease are seen in HIV-infected persons
  • Traditional risk factors, HIV-related factors, and ART-related factors contribute to the increased prevalence
The unequivocal success of ART in controlling HIV replication and restoring immune function has been tempered by the recognition of important metabolic complications resulting from the interplay between traditional risk factors for cardiovascular disease, HIV infection, and antiretroviral medications. Increased rates of dyslipidemia, abnormal glucose metabolism, and cardiovascular disease have been demonstrated in a multitude of studies involving HIV-infected persons, in a variety of settings. This module focuses on these 3 important complications, discussing risk factors, mechanisms, diagnosis, treatment, and prevention. Where appropriate, special considerations for resource-limited settings are addressed.

Risk Factors and Mechanisms of Dyslipidemia: HIV Infection vs Antiretroviral Therapy

  • Traditional risk factors for dyslipidemia remain relevant to HIV-infected patients
    • These include older age, male sex, family history, poor diet, increased BMI, and sedentary lifestyle
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