Metabolic syndrome and combined highly active antiretroviral therapy

Abstract

Metabolic complications, including dyslipidemia, insulin resistance, and altered fat distribution, (i.e. lypodistrophy), which is manifested as a loss of subcutaneous fat and a relative increase in central fat, are common in adults infected with hu-man immunodeficiency virus (HIV) who are receiving highly active antiretroviral therapy (HAART). These metabolic COM-plications increase the risk of cardiovascular disease (coronary disease, acute myocardial infarction) and cerebrovascular disease, increasing morbidity and mortality in this population. Metabolic syndrome is the consequence of the dynamic relationship between HIV virus and a host, which is influenced by the viral characteristics, genetic factors of a host, environ-mental factors, and the HAART. The potential to induce metabolic syndrome varies among antiretroviral drugs from of the same class, as well as between different classes of drugs. The development of algorithms for the screening, prediction, prevention and treatment of cardiovascular disease is the new challenge for the doctors and requires new studies in this area.