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Article Dans Une Revue Expert Opinion on Drug Safety Année : 2019

Metabolic complications affecting adipose tissue, lipid and glucose metabolism associated with HIV antiretroviral treatment

Laurie Soulat-Dufour
Sylvie Lang
  • Fonction : Auteur
Stephane Ederhy
  • Fonction : Auteur
Yann Ancedy
  • Fonction : Auteur
Anne-Sophie Beraud
  • Fonction : Auteur
Saroumadi Adavane-Scheuble
  • Fonction : Auteur
Marion Chauvet-Droit
  • Fonction : Auteur
Nadjib Hammoudi
  • Fonction : Auteur
Aliocha Scheuble
  • Fonction : Auteur
Pascal Nhan
  • Fonction : Auteur
Magali Charbonnier
  • Fonction : Auteur
Ariel Cohen
  • Fonction : Auteur

Résumé

Introduction: Efficient antiretroviral-treatment (ART) generally allows control of HIV infection. However, persons-living-with-HIV (PLWH), when aging, present a high prevalence of metabolic diseases. Area covered: Altered adiposity, dyslipidemias, insulin resistance, diabetes, and their consequences are prevalent in PLWH and could be partly related to ART. Expert opinion: At first, personal and lifestyle factors are involved in the onset of these complications. The persistence of HIV in tissue reservoirs could synergize with some ART and enhance metabolic disorders. Altered fat repartition, diagnosed as lipodystrophy, has been related to first-generation nucleoside-reverse-transcriptase-inhibitors (NRTIs) (stavudine zidovudine) and some protease inhibitors (PIs). Recently, use of some integrase-inhibitors (INSTI) resulted in weight/fat gain, which represents a worrisome unresolved situation. Lipid parameters were affected by some first-generation NRTIs, non-NRTIs (efavirenz) but also PIs boosted by ritonavir, with increased total and LDL-cholesterol and triglycerides. Insulin resistance is common associated with abdominal obesity. Diabetes incidence, high with first-generation-ART (zidovudine, stavudine, didanosine, indinavir) has declined with contemporary ART close to that of the general population. Metabolic syndrome, a dysmetabolic situation with central obesity and insulin resistance, and liver steatosis are common in PLWH and could indirectly result from ART-associated fat gain and insulin resistance. All these dysmetabolic situations increase the atherogenic cardiovascular risk.
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Dates et versions

hal-02284337 , version 1 (11-09-2019)

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Citer

Laurie Soulat-Dufour, Sylvie Lang, Stephane Ederhy, Yann Ancedy, Anne-Sophie Beraud, et al.. Metabolic complications affecting adipose tissue, lipid and glucose metabolism associated with HIV antiretroviral treatment. Expert Opinion on Drug Safety, 2019, 18 (9), pp.829-840. ⟨10.1080/14740338.2019.1644317⟩. ⟨hal-02284337⟩
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