The metabolic toxicities of antiretroviral therapy
The metabolic toxicities of antiretroviral therapy
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DOI：
10.1258/0956462011923714
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发表时间：
2001-09-01
影响因子：
1.4
通讯作者：
Easterbrook, PJ
中科院分区：
文献类型：
--
作者：
Herman, JS;Easterbrook, PJ
自从20世纪90年代中期采用高效抗逆转录病毒疗法(HAART)以来，人们越来越认识到某些代谢毒性。这些症状包括脂肪重新分布综合征(脂肪肥大、脂肪萎缩)、高脂血症、糖代谢改变和胰岛素抵抗、线粒体毒性(表现为贫血、肌病、胰腺炎、神经病变、肝脏脂肪变性和乳酸中毒)以及骨密度异常(骨质疏松和骨坏死)。代谢并发症主要见于蛋白水解酶抑制剂和核苷逆转录酶抑制剂，但也可见于所有类别的抗逆转录病毒治疗。在这篇综述中，我们总结了这些不同毒性的流行病学、发病机制和处理。
Since the adoption of highly active antiretroviral therapy (HAART) in the mid-1990s, certain metabolic toxicities have been increasingly recognized. These include a fat redistribution syndrome (lipohypertrophy, lipoatrophy), hyperlipidaemia, altered glucose metabolism and insulin resistance, mitochondrial toxicity (presenting as anaemia, myopathy, pancreatitis, neuropathy, hepatic steatosis and lactic acidosis), and bone density abnormalities (osteoporosis and osteonecrosis). Metabolic complications are principally reported with protease inhibitors and nucleoside reverse transcriptase inhibitors, but may be seen with all classes of antiretroviral therapy. In this review, we summarize the epidemiology, pathogenesis and management of these various toxicities.