Management of the metabolic effects of HIV and HIV drugs.

Management of the metabolic effects of HIV and HIV drugs.
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DOI:
10.1038/nrendo.2011.151
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发表时间:
2011-09-20
期刊:
Nature reviews. Endocrinology
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形态学和代谢异常,包括皮下脂肪组织消耗、中央脂肪组织堆积、血脂异常和葡萄糖代谢紊乱,在接受高效抗逆转录病毒治疗 (HAART) 的 HIV 感染患者中很常见,并增加了该人群患心血管疾病的风险。这些疾病的发病机制是由于慢性 HIV 感染、HAART 药物和患者因素(包括遗传易感性)之间复杂的相互作用造成的。 HAART 已将许多患者的 HIV 转变为慢性疾病,因此在发达国家许多地区,大多数 HIV 感染患者年龄≥50 岁。由于代谢和心血管疾病随着年龄的增长而增加,因此了解这些疾病的最佳管理对于护理艾滋病毒感染者的从业人员(包括内分泌专家)至关重要。本综述重点介绍了这些疾病的临床管理,重点关注有关治疗策略疗效、新可用药物以及 HAART 药物与用于治疗代谢性疾病的药物之间潜在相互作用的最新证据。
Morphologic and metabolic abnormalities, including subcutaneous adipose tissue wasting, central adipose tissue accumulation, dyslipidemia and disorders of glucose metabolism are common among HIV-infected patients receiving highly active antiretroviral therapy (HAART) and contribute to the risk of cardiovascular disease in this population. The pathogenesis of these disorders is due to complicated interactions between effects of chronic HIV infection, HAART medications, and patient factors, including genetic susceptibility. HAART has transformed HIV into a chronic condition for many patients and as a result the majority of HIV-infected patients in many areas of the developed world are ≥50 years. Since metabolic and cardiovascular diseases increase with aging, knowledge of the optimal management of these conditions is essential for practitioners caring for HIV-infected patients, including endocrine subspecialists. This Review highlights the clinical management of these disorders, focusing on the most recent evidence regarding the efficacy of treatment strategies, newly available medications and potential interactions between HAART medications and medications used to treat metabolic disorders.
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