Cellular mechanisms of lipodystrophy induction by HIV protease inhibitors

abstract

Increasing clinical evidence indicates that the use of HIV protease inhibitors (PIs) as part of highly active antiretroviral therapy (HAART) is linked closely to the pathogenesis of dyslipidemia, insulin resistance and lipodystrophy in HIV patients. However, the underlying cellular and molecular mechanisms remain elusive. Recent clinical and in vitro studies suggest that HIV PIs have multiple effects on different types of cells in the body, and that individual HIV PIs differ in their ability to induce dyslipidemia, insulin resistance and lipodystrophy. This review summarizes the recent evidence for potential cellular mechanisms of HIV PI-associated lipodystrophy. Understanding of the cellular mechanisms of HIV

PI-induced side effects is of great clinical importance and will provide novel information for the development of improved therapeutic strategies.

Keywords:

• Adipocytes
• Hepatocytes
• Hiv protease inhibitors
• Lipodystrophy
• Macrophages
• Sterol regulatory element binding protein
• Unfolded protein response