<p>Antiretroviral Therapy-Associated Metabolic Complications: Review of the Recent Studies</p>

Abstract

The extensive utilization of antiretroviral therapy (ART) has successfully improved human immunodeficiency virus (HIV)-associated complications. The incidence of opportunistic infections is decreased by the viral load suppression and the CD4 count promotion. However, metabolic complications, commonly bone demineralization, lipodystrophy, and lactic acidosis, are arising following the adaptation of long-term ART. The events are not drug-specific, but the severity and incidence individually vary depending upon classes of drugs. Such concerning occurrences may lead to discontinuation of current therapy or switching to another regimen with fewer adverse effects. The purpose of this review is to demonstrate the common metabolic abnormalities associated with each class of widely used ART in people living with HIV (PLHIV). Electronic databases such as PubMed, ScienceDirect, Scopus, Google Scholar, SciFinder, and Web of Science were used for the literature search. A better understanding of ART-associated metabolic adverse effects is helpful in various clinical settings so that therapists may optimize treatments in this population.

Knowledge, Attitude and Practice survey on healthy lifestyle in people with HIV

“…These events are not specific to a type of antiretroviral drug, but the severity and incidence vary individually, depending on drug classes, which may lead to discontinuation of therapy or switching to regimens with fewer adverse effects. 3 Studies also show that PLHIV who use alcohol and illicit drugs have reduced HAART compliance and viral suppression, in addition to toxicity, as the drugs interact with antiretrovirals, resulting in risk for liver disease, dysfunctions in drug absorption and metabolism, in addition to reducing the effectiveness of treatment and increasing the chances of virus transmission and co-infections. 4,5 Inflammation and smoking are independent predictors of morbidity and mortality in PLHIV, as the burden of smoking exacerbates inflammation, with the hypothesis that greater intensity and duration of smoking is associated with an increase in C-reactive protein, an inflammatory marker.…”

Inquérito de Conhecimento, Atitude e Prática sobre estilo de vida saudável em pessoas com HIV

“…Esses eventos não são específicos a um tipo de antirretroviral, mas a gravidade e a incidência variam individualmente, a depender das classes de medicamentos, o que pode levar à descontinuação da terapia ou mudança para regimes com menos efeitos adversos. 3 Estudos também mostram que PVHIV que utilizam álcool e drogas ilícitas têm adesão à HAART e supressão viral reduzidas, além da toxicidade, pois as drogas interagem com os antirretrovirais, resultando em risco para doenças hepáticas, disfunções na absorção e metabolismo dos fármacos, além de reduzir a eficácia do tratamento e aumentar as chances de transmissão do vírus e coinfecções. 4,5 A inflamação e o tabagismo são preditores independentes de morbimortalidade em PVHIV, pois a carga do tabagismo exacerba a inflamação, tendo-se a hipótese de que a maior intensidade e duração do tabagismo tem associação com o aumento da proteína C-reativa, um marcador inflamatório.…”

Prevalence and predictors of glucose metabolism disorders among People Living with HIV on combination antiretroviral therapy

“…During long-term exposure to antiretroviral therapy (ART), individual patients may experience treatment-associated adverse events or drug toxicities [ 5 ]. Long-term exposure to ART may increase the risk of metabolic abnormalities such as lactic acidosis, osteopenia, dyslipidemia, and glucose metabolism disorders (GMDs) [ 6 ]. GMDs are glucose homeostasis dysregulations that include diabetes mellitus (DM), impaired glucose tolerance (IGT), impaired fasting glycemia (IFG), or insulin resistance (IR) [ 7 ].…”

“…DM is now emerging as one of the non-infectious comorbid conditions among People Living with HIV (PLWH) on cART [8]. Previous studies reported that patients on ART were found to be four-fold more prone to DM and associated conditions compared to HIV uninfected individuals [6,7,[9][10][11]. Among cART classes, protease inhibitors (PI) use has been commonly reported to have association with GMDs.…”