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Pathogenesis of Antiretroviral Treatment-Associated Metabolic Syndrome

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Cardiovascular Disease in AIDS

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Abstract

Highly active antiretroviral therapy (ART) with protease inhibitors (PIs) and nucleoside analogue inhibitors of viral reverse transcriptase (NRTI) allowed a major reduction in the severity and morbidity of HIV infection; however, these drugs were associated with the occurrence of secondary effects collectively termed “ART-related lipodystrophy or metabolic syndrome.” This syndrome is defined by alterations in body-fat repartition with peripheral fat loss and/or central fat accumulation together with metabolic disorders such as hypertriglyceridemia (hyper-TG), hypercholesterolemia, and insulin resistance sometimes with altered glucose tolerance. This set of abnormalities shows some similarities with those present in the very common metabolic or insulin-resistance syndrome and some of the pathophysiological mechanisms are probably the same. In addition, the ART-related metabolic syndrome probably results from alterations directly related to the treatment and also probably to the ongoing infection in the context of altered immunity and modified cytokine profile, which most likely enhances its severity and could be responsible for its specific features.

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Authors and Affiliations

  1. INSERM U402, Faculté de Médecine Saint-Antoine, Département de Biochimie, Hôpital Tenon, Université Pierre et Marie Curie, Paris, France

    J. Capeau

  2. INSERM UMRS680, Faculté de Médecine Saint-Antoine, Paris, France

    M. Caron

  3. Département de Cardiologie, Centre Hospitalier Universitaire Saint-Antoine, Assistance Publique — Hôpitaux de Paris and Université Pierre et Marie Curie, Paris, France

    F. Boccara

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  1. J. Capeau
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  2. M. Caron
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  3. F. Boccara
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Editors and Affiliations

  1. Department of Medical Pathophysiology, “Sapienza” University of Rome, Rome, Italy

    Giuseppe Barbaro

  2. Department of Cardiology Saint Antoine University Hospital, Assistance Publique - Hôpitaux de Paris and Université Pierre et Marie Curie Paris, France

    Franck Boccara

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Capeau, J., Caron, M., Boccara, F. (2009). Pathogenesis of Antiretroviral Treatment-Associated Metabolic Syndrome. In: Barbaro, G., Boccara, F. (eds) Cardiovascular Disease in AIDS. Springer, Milano. https://doi.org/10.1007/978-88-470-0761-1_3

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