Published online May 12, 2015. doi: 10.5501/wjv.v4.i2.56
Peer-review started: October 28, 2014
First decision: November 27, 2014
Revised: February 9, 2015
Accepted: March 5, 2015
Article in press: March 9, 2015
Published online: May 12, 2015
For human immunodeficiency virus (HIV)-infected patients, the 1990s were marked by the introduction of highly active antiretroviral therapy (HAART) representing a new perspective of life for these patients. The use of HAART was shown to effectively suppress the replication of HIV-1 and dramatically reduce mortality and morbidity, which led to a better and longer quality of life for HIV-1-infected patients. Apart from the substantial benefits that result from the use of various HAART regimens, laboratory and clinical experience has shown that HAART can induce severe and considerable adverse effects related to metabolic complications of lipid metabolism, characterized by signs of lipodystrophy, insulin resistance, central adiposity, dyslipidemia, increased risk of cardiovascular disease and even an increased risk of atherosclerosis. New drugs are being studied, new therapeutic strategies are being implemented, and the use of statins, fibrates, and inhibitors of intestinal cholesterol absorption have been effective alternatives. Changes in diet and lifestyle have also shown satisfactory results.
Core tip: Antiretroviral therapy inhibits human immunodeficiency virus (HIV)-1 replication, reduces mortality and increases survival. On the other hand, HIV-1 infection and antiretroviral therapy affect lipid metabolism. In fact, lipodystrophy is a well-documented side effect of highly active antiretroviral therapy (HAART). Switching to a less metabolically active drug improve HAART-associated dyslipidemia. Other therapies may include statins, fibrates, inhibitors cholesterol absorption, fish oils, niacin. Moreover, changes in diet and lifestyle are needed to revert the dyslipidemia.