Management of Metabolic Side Effects of Antiretoviral Drugs in Patients Infected with Human Immunodeficiency Virus

摘要

Acquired immunodeficiency syndrome (AIDS) is a human immune systemic disease caused by the human immunodeficiency virus (HIV). This condition reduces progressively the effectiveness of the immune system and leaves individuals susceptible to infection and tumors. Antiretroviral treatment reduces the mortality and the morbidity of HIV infection but the treatment is associated with increasing reports of metabolic abnormalities such as body fat abnormalities, impaired glucose metabolism and insulin resistance, and dyslipidemia. All these metabolic side effects of antiretroviral therapy combined with effect of HIV infection seem to play a key role in the increased cardiovascular risk of these patients. The modification of cardiovascular risk factors has become an important aspect of HIV management. All treatment strategies should emphasize cardiovascular risk reduction, focusing particularly on hypertension control and correction of glycemic parameters, and dyslipidemia. Switching antiretrovirals may result in improvements of cardiovascular risk factors, but special care must be taken to avoid virologic failure with such substitutions. The treatment of cardiovascular risk factors in HIV often involves polypharmacy, which increases the risk of suboptimal adherence and may compromise the benefit of antiretroviral drugs.