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Metabolic Consequences of Antiretroviral Therapy

  • HIV Pathogenesis and Treatment (AL Landay and NS Utay, Section Editors)
  • Published:
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Abstract

Purpose of Review

This review reports on published studies describing metabolic changes associated with antiretroviral therapy (ART) to treat HIV disease including a historical perspective of earlier ART agents, but with the main focus on newer ART agents currently in use.

Recent Findings

Studies from different countries around the world have shown that integrase inhibitor (INSTI)-based regimens as well as tenofovir alafenamide (TAF) are associated with weight gain, with women and people of black race at especially high risk. Some studies preliminarily suggest worsened metabolic outcomes associated with this weight gain including adverse effects on glucose homeostasis.

Summary

Antiretroviral therapy can affect weight, adipose tissue, glucose, and lipids. As obesity is prevalent and increasing among people with HIV, awareness of risk factors for weight gain, including the ART medications associated with greater weight gain, are needed in order to inform prevention efforts. Further research is needed to better understand the long-term health consequences of INSTI- and TAF-associated weight increases.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Dr. Lo received funding from the National Institutes of Health and an investigator-initiated research grant from Viiv Healthcare for research and not for this review.

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  1. Metabolism Unit, Division of Endocrinology, Massachusetts General Hospital, LON-207, 55 Fruit Street, Boston, MA, 02114, USA

    Caroline E. Diggins, Samuel C. Russo & Janet Lo

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Janet Lo has previously served as a consultant for Viiv Healthcare and on medical affairs advisory boards for Gilead Sciences. She is also a Co-Principal Investigator on an investigator-initiated research grant funded by Viiv Healthcare.

Caroline Diggins and Samuel Russo declare that they have no conflict of interest.

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Diggins, C.E., Russo, S.C. & Lo, J. Metabolic Consequences of Antiretroviral Therapy. Curr HIV/AIDS Rep 19, 141–153 (2022). https://doi.org/10.1007/s11904-022-00600-6

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