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)


  • Metformin is the only agent endorsed by the American Diabetes Association for the prevention of diabetes
    • Can be considered for patients with impaired glucose tolerance, impaired fasting glucose, or an A1C of 5.7% to 6.4%, particularly those younger than 60 years of age, those with a BMI ≥ 35, and women with previous gestational diabetes mellitus)[ADA 2013a]
  • Metformin has been shown to improve insulin resistance and decrease body weight after 3 months of therapy in small studies in HIV-infected patients, particularly for patients with lipodystrophy and elevated levels of fasting insulin[Hadigan 2000; van Wijk 2005]

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