Metabolic complications associated with antiretroviral therapy

Jain, Renu; Furfine, Eric S.; Pedneault, Louise; White, Alex J.; Lenhard, James M.

doi:10.1016/s0166-3542(01)00148-6

Cited by 132 publications

(111 citation statements)

References 117 publications

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“…Several studies have shown high prevalence of these changes in HIV-infected patients according to these criteria [1][2][3][4][6][7][8][9][10][11]. The multiple factors listed as promoters of osteopenia include direct effects of the virus on osteogenic cells; persistent activation of proinflammatory cytokines, mainly TNF-α and interleukin-1; changes in vitamin D metabolism, with deficit of 1,25 di-hydrovitamin D, as well as the involvement of mitochondrial abnormalities related with lactic acidemia and the development of opportunistic diseases [4,5].…”

Section: Osteopenia/osteoporosismentioning

confidence: 99%

“…Studies on the influence of antiretroviral treatment show that the relative risk is higher when protease inhibitors are used, and indinavir is known to inhibit bone formation, while ritonavir inhibits osteoclast differentiation and function [1,6,7,[9][10][11]. Regarding reverse transcriptase inhibitors, recent reports have linked tenofovir to the occurrence of osteomalacia and the Fanconi syndrome [12].…”

Section: Osteopenia/osteoporosismentioning

confidence: 99%

“…In HIV-positive patients it is important to exclude or control risk factors other than the ones of the disease itself and the antiretroviral drug. In oligosymptomatic subjects the treatment may be based on the use of analgesics and non-hormonal anti-inflammatory agents [6].…”

Section: Osteonecrosismentioning

confidence: 99%

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Osteoarticular complications related to HIV infection and highly active antiretroviral therapy

Lima¹,

Zumiotti²,

Camanho³

et al. 2007

Braz J Infect Dis

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With the significant increase in life expectancy for HIV-infected patients in the era of high potency antiretroviral therapy, major metabolic changes have been observed due to the prolonged period of the viral infection and the treatment itself. Osteoarticular changes resulting from these processes are mainly reported in long term HIVinfected patients receiving high potency antiretroviral therapy and include osteopenia/osteoporosis, osteonecrosis, carpal tunnel syndrome and adhesive capsulitis of the shoulder.

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Section: Osteopenia/osteoporosismentioning

confidence: 99%

Section: Osteopenia/osteoporosismentioning

confidence: 99%

See 1 more Smart Citation

Osteoarticular complications related to HIV infection and highly active antiretroviral therapy

Lima¹,

Zumiotti²,

Camanho³

et al. 2007

Braz J Infect Dis

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“…However, ART is not able to eradicate HIV from an infected host (6)(7)(8). Further, long-term therapy is not devoid of adverse effects such as drug toxicities, costs, and the selection of drug-resistant variant viruses in partially adherent patients (9)(10)(11). ART also impinges on cellular immunity; prolonged control of viral replication is associated with a beneficial increase in CD4 ϩ T cell counts (12), but also with decreasing HIV-specific cellular immune responses in patients with chronic HIV-1 infection (13,14).…”

mentioning

confidence: 99%

Stimulation of HIV-specific cellular immunity by structured treatment interruption fails to enhance viral control in chronic HIV infection

Oxenius

Price

Günthard

et al. 2002

Proc. Natl. Acad. Sci. U.S.A.

194

167

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Potent antiretroviral therapy (ART) suppresses HIV-1 viral replication and results in decreased morbidity and mortality. However, prolonged treatment is associated with drug-induced toxicity, emergence of drug-resistant viral strains, and financial constraints. Structured therapeutic interruptions (STIs) have been proposed as a strategy that could boost HIV-specific immunity, through controlled exposure to autologous virus over limited time periods, and subsequently control viral replication in the absence of ART. Here, we analyzed the impact of repeated STIs on virological and immunological parameters in a large prospective STI study. We show that: (i) the plateau virus load (VL) reached after STIs correlated with pretreatment VL, the amount of viral recrudescence during the treatment interruptions, and the off-treatment viral rebound rate; (ii) the magnitude and the breadth of the HIV-specific CD8 ؉ T lymphocyte response, despite marked interpatient variability, increased overall with STI. However, the quantity and quality of the post-STI response was comparable to the response observed before any therapy; (iii) individuals with strong and broad HIVspecific CD8 ؉ T lymphocyte responses at baseline retained these characteristics during and after STI; (iv) the increase in HIV-specific CD8 ؉ T lymphocyte frequencies induced by STI was not correlated with decreased viral set point after STI; and (v) HIV-specific CD4 ؉ T lymphocyte responses increased with STI, but were subsequently maintained only in patients with low pretreatment and plateau VLs. Overall, these data indicate that STI-induced quantitative boosting of HIV-specific cellular immunity was not associated with substantial change in viral replication and that STI was largely restoring pretherapy CD8 ؉ T cell responses in patients with established infection.

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“…7 The increased prevalence of lipodystrophy has been linked to prolonged duration of antiretroviral therapy. 8,9 Nevertheless, survival benefits of antiretroviral therapy outweigh the adverse effect of lipodystrophy, 10 resulting in lifelong use of antiretroviral drugs. However, body changes due to lipodystrophy may stigmatize patients, causing low self-esteem, problems in social and sexual relations, anxiety, and depression.…”

Section: Introductionmentioning

confidence: 99%

Effect of Lipodystrophy on the Quality of Life among People Living with HIV (PLHIV) on Highly Active Antiretroviral Therapy

Shenoy

Ramapuram

Unnikrishan

et al. 2013

J Int Assoc Provid AIDS Care

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Background: Lipodystrophy is a known adverse effect of highly active antiretroviral therapy (HAART). Lipodystrophy resulting in body dysmorphism can lower the quality of life (QoL) among HAART recipients. The main aim of our study was to find the effect of lipodystrophy on QoL among people living with HIV (PLHIV) on HAART. Methods: This cross-sectional study was conducted in a tertiary care hospital in south India. The participants were assessed for the presence of lipodystrophy. Their QoL was assessed using HIV-AIDS-targeted QoL questionnaire (HAT-QoL). Statistical analysis was carried out using SPSS version 11.5. Results: Lipodystrophy was present in 21 participants (42%). The QoL among individuals with lipodystrophy was found to be significantly lower in terms of disclosure worries (P ¼ .023) and financial worries (P ¼ .049). Conclusions: Lipodystrophy adversely affects QoL among PLHIV. There is a need for studies analyzing factors that can potentially improve the QoL in such individuals.

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Metabolic complications associated with antiretroviral therapy

Cited by 132 publications

References 117 publications

Osteoarticular complications related to HIV infection and highly active antiretroviral therapy

Osteoarticular complications related to HIV infection and highly active antiretroviral therapy

Stimulation of HIV-specific cellular immunity by structured treatment interruption fails to enhance viral control in chronic HIV infection

Effect of Lipodystrophy on the Quality of Life among People Living with HIV (PLHIV) on Highly Active Antiretroviral Therapy

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