Metabolic syndrome associated with HIV and highly active antiretroviral therapy
Metabolic syndrome associated with HIV and highly active antiretroviral therapy
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DOI：
10.1007/s11892-009-0008-7
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发表时间：
2009-02-01
影响因子：
4.2
通讯作者：
Iacobellis, Gialuca
中科院分区：
文献类型：
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作者：
Barbaro, Giuseppe;Iacobellis, Gialuca
高效抗逆转录病毒疗法(HAART)的引入显著改善了HIV疾病的临床结局，提高了存活率。然而，一些HAART方案，特别是包括酶抑制剂在内的那些方案，已被证明在高比例的艾滋病毒感染患者中引起代谢(血脂异常、胰岛素抵抗)和躯体(脂营养不良/脂肪萎缩)变化，与心血管疾病(冠状动脉疾病和中风)的风险增加相关。HAART相关代谢综合征及其动脉粥样硬化的发病机制复杂，涉及多种因素，包括HAART对脂代谢、内皮细胞和脂肪细胞功能的直接影响、促炎细胞因子的激活以及线粒体功能障碍。更好地了解导致这种综合征的分子机制将导致发现新的药物，这些药物将减少面临长期HAART的HIV感染患者的脂肪营养不良和相关代谢并发症的发生率。
The introduction of highly active antiretroviral therapy (HAART) has significantly improved the clinical outcome of HIV disease with increased survival rates. However, some HAART regimens, especially those including protease inhibitors, have been shown to cause in a high proportion of HIV-infected patients metabolic (dyslipidemia, insulin resistance) and somatic (lipodystrophy/lipoatrophy) changes that are associated with an increased risk of cardiovascular disease (coronary artery disease and stroke). The pathogenesis of HAART-associated metabolic syndrome and of its atherogenic profile is complex, and several factors are involved, including direct effects of HAART on lipid metabolism, endothelial and adipocyte cell function, activation of proinflammatory cytokines, and mitochondrial dysfunction. A better understanding of the molecular mechanisms responsible for this syndrome will lead to the discovery of new drugs that will reduce the incidence of lipodystrophy and related metabolic complications in HIV-infected patients facing long-term HAART.