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vol.56 issue2Acquired inmunodeficiency syndrome-related lymphoma: 1.Evolution during the 20 years of the epidemic. 2. The experience at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán: 1986-2003Epidemiology of the metabolic abnormalitis in patients with HIV infections author indexsubject indexsearch form
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Revista de investigación clínica

Print version ISSN 0034-8376

Abstract

RODRIGUEZ CARRANZA, Sandra I.  and  AGUILAR SALINAS, Carlos A.. Metabolic abnormalities in patients with HIV infection. Rev. invest. clín. [online]. 2004, vol.56, n.2, pp.193-208. ISSN 0034-8376.

Highly active antiretroviral therapy (HAART) decreased the mortality of patients with HIV infection, but its effects on the metabolism of lipoproteins, carbohydrates and adipose tissue are a common cause for seeking treatment. Our purpose is to present the current knowledge available regarding the epidemiology, pathophysiology, diagnosis and treatment of these conditions. A discussion about the limitations of the current evidence is included. HIV-related dyslipidemia is multifactorial. Prior to the treatment, hypertriglyceridemia is found frequently,usually with low cholesterol and HDL cholesterol levels. Antiretroviral agents, especially some protease inhibitors, have adverse effects on plasma lipids. Nutritional recovery and lipodistrophy exacerbate the lipid abnormalities. Hypertriglyceridemia (usually moderate to severe) and moderate hypercholesterolemia (< 300 mg/dL) are the most common end-results. Subcutaneous fat of the face and limbs decreases and it is deposited in the neck and in the abdomen. The diagnosis and treatment of these conditions are controversial due to the lack of appropiate evidence. The metabolic complications of HAART could be a leading cause of mortality in the near future. Thus, longitudinal studies, including subjects from several ethnic groups are needed to identify the main factors involved in the pathophysiology and to assess several therapeutical and preventive strategies. Collaboration between HIV specialists and other health professionals (i.e. endocrinologysts) will be required to accomplish these goals.

Keywords : Human immunodeficiency virus; Dyslipidemias; Antiretrovirals; Protease inhibitors; Lipodistrophy.

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