Weight Gain After HIV Therapy Initiation: Pathophysiology and Implications.
Weight Gain After HIV Therapy Initiation: Pathophysiology and Implications.
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HIV治疗开始后体重增加：病理生理学和意义。
DOI：
10.1210/clinem/dgad411
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发表时间：
2024-01-18
期刊：
影响因子：
--
通讯作者：
中科院分区：
文献类型：
--
作者：
现代艾滋病毒抗逆转录病毒疗法（ART）的效力，安全性和可用性的快速进步使大多数艾滋病毒感染者（PLWH）的预期寿命接近正常。具有讽刺意味的是，考虑到艾滋病毒/艾滋病的历史（最初被称为“苗条病”，因为相关的体重减轻），许多人开始艾滋病毒治疗面临的最新困境是体重增加和肥胖，特别是黑人，妇女和那些开始治疗晚期免疫缺陷的人。我们回顾了艾滋病病毒感染者体重增加的病理生理学和对ART的影响，并讨论了为什么这种现象只是最近才被认识到，尽管有效的治疗方法已经有近30年了。我们全面探讨了原因的理论，从最初的猜测，体重增加只是从浪费中恢复的人恢复健康，到新方案与先前有毒药物的比较效果，再到药物对线粒体功能的直接影响。然后，我们讨论了体重增加对现代ART的影响，特别是对脂质，葡萄糖代谢和炎症标志物的伴随作用。最后，我们讨论了PLWH和肥胖的干预方案，从切换ART方案或方案内的特定药物的限制，体重增加缓解策略，以及获得新兴抗肥胖药物的潜在希望，这些药物尚未在该人群中进行评估。
Rapid advances in the potency, safety, and availability of modern HIV antiretroviral therapy (ART) have yielded a near-normal life expectancy for most people living with HIV (PLWH). Ironically, considering the history of HIV/AIDS (initially called “slim disease” because of associated weight loss), the latest dilemma faced by many people starting HIV therapy is weight gain and obesity, particularly Black people, women, and those who commenced treatment with advanced immunodeficiency. We review the pathophysiology and implications of weight gain among PLWH on ART and discuss why this phenomenon was recognized only recently, despite the availability of effective therapy for nearly 30 years. We comprehensively explore the theories of the causes, from initial speculation that weight gain was simply a return to health for people recovering from wasting to comparative effects of newer regimens vs prior toxic agents, to direct effects of agents on mitochondrial function. We then discuss the implications of weight gain on modern ART, particularly concomitant effects on lipids, glucose metabolism, and inflammatory markers. Finally, we discuss intervention options for PLWH and obesity, from the limitations of switching ART regimens or specific agents within regimens, weight-gain mitigation strategies, and potential hope in access to emerging antiobesity agents, which are yet to be evaluated in this population.
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影响因子：
4.9
作者：
Domingo, Pere;Villarroya, Francesc;Domingo, Joan Carles
通讯作者：
Domingo, Joan Carles
DOI：
10.1002/oby.23005
发表时间：
2020-12
期刊：
Obesity (Silver Spring, Md.)
影响因子：
--
作者：
Manne-Goehler J;Baisley K;Vandormael A;Bärnighausen T;Tanser F;Herbst K;Pillay D;Siedner MJ
通讯作者：
Siedner MJ
影响因子：
15.1
作者：
Brennan, Alana T.;Nattey, Cornelius;Kileel, Emma M.;Rosen, Sydney;Maskew, Mhairi;Stokes, Andrew C.;Fox, Matthew P.;Venter, Willem D. F.
通讯作者：
Venter, Willem D. F.
影响因子：
1.6
作者：
Darnell J;Jain S;Sun X;Qin H;Reynolds T;Karris MY;Hill LA
通讯作者：
Hill LA
影响因子：
3.7
作者：
de Waal R;Cohen K;Maartens G
通讯作者：
Maartens G