Mechanisms of HIV-related dyslipidemia

摘要

Dyslipidemia in HIV infection is common and is of concern owing to reports of premature atherosclerosis and cardiovascular disease in HIV-infected individuals. HIV infection itself has been associated with lower high-density lipoprotein-cholesterol and low-density lipoprotein-cholesterol, but higher triglycerides. Antiretroviral therapy has also been associated with dyslipidemia, particularly hypertriglyceridemia. The proposed underlying mechanisms by which HIV infection and antiretroviral therapy cause alterations in high-density lipoprotein, low-density lipoprotein and triglycerides will be explored in this review, including the host response to HIV leading to alterations in lipids and lipoproteins, as well as the effect of HIV on cellular lipid metabolism. The effects of specific classes of antiretroviral drugs and individual antiretroviral drugs on dyslipidemia will also be examined. An understanding of the potential mechanisms leading to dyslipidemia in HIV infection will provide insight into the development of lipid-improving therapies targeted to HIV-specific pathways.