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Obesity and Weight Gain in Persons with HIV

Abstract

Purpose of Review

The proportion of overweight and obese persons with HIV (PWH) has increased since the introduction of antiretroviral therapy (ART). We aim to summarize recent literature on risks of weight gain, discuss adipose tissue changes in HIV and obesity, and synthesize current understanding of how excess adiposity and HIV contribute to metabolic complications.

Recent Findings

Recent studies have implicated contemporary ART regimens, including use of integrase strand transfer inhibitors and tenofovir alafenamide, as a contributor to weight gain, though the mechanisms are unclear. Metabolic dysregulation is linked to ectopic fat and alterations in adipose immune cell populations that accompany HIV and obesity. These factors contribute to an increasing burden of metabolic diseases in the aging HIV population.

Summary

Obesity compounds an increasing burden of metabolic disease among PWH, and understanding the role of fat partitioning and HIV- and ART-related adipose tissue dysfunction may guide prevention and treatment strategies.

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Fig. 1

References

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Funding

This work was supported by the National Institutes of Health grants T32AI00747426, K12HL143956, and R01DK112262.

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Correspondence to John R. Koethe.

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Samuel Bailin, Curtis Gabriel, Celestine Wanjalla, and John Koethe declare that they have no conflicts of interest.

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Bailin, S.S., Gabriel, C.L., Wanjalla, C.N. et al. Obesity and Weight Gain in Persons with HIV. Curr HIV/AIDS Rep 17, 138–150 (2020). https://doi.org/10.1007/s11904-020-00483-5

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Keywords

  • Obesity
  • HIV
  • Metabolic disease
  • Weight gain
  • Adipose tissue
  • Inflammation