Practical Review of Recognition and Management of Obesity and Lipohypertrophy in Human Immunodeficiency Virus Infection
Practical Review of Recognition and Management of Obesity and Lipohypertrophy in Human Immunodeficiency Virus Infection
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DOI：
10.1093/cid/cix178
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发表时间：
2017-05-15
影响因子：
11.8
通讯作者：
Erlandson, Kristine M.
中科院分区：
文献类型：
--
作者：
Lake, Jordan E.;Stanley, Takara L.;Erlandson, Kristine M.
背景肥胖和脂肪增生在接受抗逆转录病毒治疗（ART）的HIV感染者中很常见，并与HIV感染者的发病率和死亡率有关。我们提出了一个共识的诊断，临床后果，并治疗过度肥胖的成人治疗艾滋病毒感染。肥胖和脂肪增生通常发生在接受抗逆转录病毒治疗的HIV感染成人中，可能具有重叠的病理生理学和/或协同代谢后果。传统的、艾滋病毒特有的和抗逆转录病毒疗法特有的风险因素都有影响。过度肥胖的代谢和炎症后果是该人群中非艾滋病事件的关键驱动因素。虽然有希望的治疗策略存在，需要进一步的研究，以更好地了解现代ART时代的肥胖和脂肪肥大的病理生理和最佳治疗。广泛性肥胖和脂肪增生在接受抗逆转录病毒治疗的艾滋病毒感染者中普遍存在。积极的诊断和管理是预防和治疗这一人群终末器官疾病的关键，对艾滋病毒感染者目前和未来的健康至关重要。
Background. Obesity and lipohypertrophy are common in treated human immunodeficiency virus (HIV) infection and contribute to morbidity and mortality among HIV-infected adults on antiretroviral therapy (ART).Methods. We present a consensus opinion on the diagnosis, clinical consequences, and treatment of excess adiposity in adults with treated HIV infection.Results. Obesity and lipohypertrophy commonly occur among HIV-infected adults on ART and may have overlapping pathophysiologies and/or synergistic metabolic consequences. Traditional, HIV-specific, and ART-specific risk factors all contribute. The metabolic and inflammatory consequences of excess adiposity are critical drivers of non-AIDS events in this population. Although promising treatment strategies exist, further research is needed to better understand the pathophysiology and optimal treatment of obesity and lipohypertrophy in the modern ART era.Conclusions. Both generalized obesity and lipohypertrophy are prevalent among HIV-infected persons on ART. Aggressive diagnosis and management are key to the prevention and treatment of end-organ disease in this population and critical to the present and future health of HIV-infected persons.