Metabolic disorders and cardiovascular consequences of HIV infection and antiretroviral therapy

Abstract

Metabolic disturbances associated with HIV disease have become an important factor in patient management and have important implications for long-term outcomes, both in regards to mortality and healthcare burden. Recent research has implicated both HIV infection itself and specific antiretroviral therapies in the development of these disorders. This review examines recent findings from research into insulin and glucose dysregulation, serum lipid abnormalities, adipose tissue and derangements in bone metabolism. This review then describes the cardiovascular consequences and management of these metabolic disorders, and summarizes current thinking on the pathogenesis and effects of antiretroviral therapy. Finally, the review raises some questions regarding ongoing challenges and unmet needs in this field of research.

Keywords::

• adipose tissue
• bone metabolism
• cardiovascular disease
• dyslipidemia
• glucose metabolism
• HIV
• insulin resistance
• metabolic syndrome

Financial & competing interests disclosure

Allison Martin has received some research funding from Gilead Sciences. Sean Emery has either served on advisory boards, received travel grants, consultancy payments or honoraria from Bristol-Myers Squibb, Gilead, Janssen-Cilag, NeuroMolecular Pharmaceuticals, RDI, Roche and Virax. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.