Switching antiretroviral therapy to minimize metabolic complications

University of California Los Angeles, Division of Infectious Diseases, Center for Clinical AIDS Research, & Education, 9911 West Pico, Boulevard, Suite 980, Los Angeles, CA 90035, USA.
HIV Therapy 11/2010; 4(6):693-711. DOI: 10.2217/hiv.10.47
Source: PubMed


Advances in HIV therapy have made living with HIV for decades a reality for many patients. However, antiretroviral therapy has been associated with multiple long-term complications, including dyslipidemia, fat redistribution, insulin resistance and increased cardiovascular risk. As newer agents with improved metabolic profiles have become available, there is growing interest in the safety and efficacy of switching ART as a strategy to reduce long-term complications. This article reviews recently published data on switching ART to minimize the contributions of specific agents to these complications.

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Available from: Jordan E Lake, Jul 15, 2015
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    Eric Walter Pefura Yone · André Pascal Kengne · Gloria Ashuntantang · Awa Foueudjeu Betyoumin · Jeanne Ngogang

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    ABSTRACT: The treatment of metabolic disease is becoming an increasingly important component of the long-term management of patients with well controlled HIV on antiretroviral therapy (ART). Metabolic diseases probably develop at the intersection of traditional risk factors (such as obesity, tobacco use, and genetic predisposition) and HIV-specific and ART-specific contributors (including chronic inflammation and immune activation). This Review discusses present knowledge on adipose tissue dysfunction, insulin-glucose homoeostasis, lipid disturbances, and cardiovascular disease risk in people with HIV on ART. Although new antiretroviral drugs are believed to induce fewer short-term metabolic perturbations than do older drugs, the long-term effects of these drugs are not fully understood. Additionally, patients remain at increased risk of cardiovascular disease and other metabolic comorbidities. Research and treatment should focus on selection of ART that is both virologically effective and has minimum metabolic effects, minimisation of traditional risk factors for metabolic disease, and development of novel therapies to treat metabolic disease in patients with HIV, including use of anti-inflammatory and immunomodulatory drugs.
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