In the late 1990s, reports of unusual changes in body fat distribution named ‘lipodystrophy’ (LD) began to appear in HIV patients mitigating the enormous enthusiasm about improvement of survival and quality of life provided by the combinations of antiretroviral (ARV) drug classes, the so-called highly active antiretroviral therapy (HAART), which had just become available at that time. The objective of this paper is to critically review the literature on LD and to discuss the impact of newer ARV agents, namely atazanavir, darunavir and raltegravir, as well as strategies of the late HAART era, including single-tablet regimens and nucleoside-sparing regimens. Studies in which LD was measured by dual-energy x-ray absorptiometry or by abdominal computed tomography or magnetic resonance imaging scan only, were included. We were unable to identify studies depicting a negative impact of drugs or ARV regimens on limb fat loss. On the contrary, a few studies identified a negative impact of atazanavir/ritonavir or darunavir/ritonavir on trunk fat increase. It should be noted that this anthropometric measure is a poor instrument since it cannot distinguish between subcutaneous and visceral fat. We conclude that presumably the body fat changes currently observed in HIV-infected patients is the net result of competing phenomena: on one side the natural history of lipohypertrophy as a result of HIV and HAART impact, and on the other side the physiological body fat changes observed in the aging population.

HIV-Associated Lipodystrophy: Impact of Antiretroviral Therapy / Guaraldi, Giovanni; Stentarelli, Chiara; Zona, Stefano; Antonella, Santoro. - In: DRUGS. - ISSN 0012-6667. - STAMPA. - 73(13):(2013), pp. 1431-1450. [10.1007/s40265-013-0108-1]

HIV-Associated Lipodystrophy: Impact of Antiretroviral Therapy

GUARALDI, Giovanni;STENTARELLI, Chiara;ZONA, Stefano;
2013

Abstract

In the late 1990s, reports of unusual changes in body fat distribution named ‘lipodystrophy’ (LD) began to appear in HIV patients mitigating the enormous enthusiasm about improvement of survival and quality of life provided by the combinations of antiretroviral (ARV) drug classes, the so-called highly active antiretroviral therapy (HAART), which had just become available at that time. The objective of this paper is to critically review the literature on LD and to discuss the impact of newer ARV agents, namely atazanavir, darunavir and raltegravir, as well as strategies of the late HAART era, including single-tablet regimens and nucleoside-sparing regimens. Studies in which LD was measured by dual-energy x-ray absorptiometry or by abdominal computed tomography or magnetic resonance imaging scan only, were included. We were unable to identify studies depicting a negative impact of drugs or ARV regimens on limb fat loss. On the contrary, a few studies identified a negative impact of atazanavir/ritonavir or darunavir/ritonavir on trunk fat increase. It should be noted that this anthropometric measure is a poor instrument since it cannot distinguish between subcutaneous and visceral fat. We conclude that presumably the body fat changes currently observed in HIV-infected patients is the net result of competing phenomena: on one side the natural history of lipohypertrophy as a result of HIV and HAART impact, and on the other side the physiological body fat changes observed in the aging population.
2013
73(13)
1431
1450
HIV-Associated Lipodystrophy: Impact of Antiretroviral Therapy / Guaraldi, Giovanni; Stentarelli, Chiara; Zona, Stefano; Antonella, Santoro. - In: DRUGS. - ISSN 0012-6667. - STAMPA. - 73(13):(2013), pp. 1431-1450. [10.1007/s40265-013-0108-1]
Guaraldi, Giovanni; Stentarelli, Chiara; Zona, Stefano; Antonella, Santoro
File in questo prodotto:
File Dimensione Formato  
2013_HIV associated lipodystrophy.pdf

Accesso riservato

Tipologia: Versione pubblicata dall'editore
Dimensione 356.36 kB
Formato Adobe PDF
356.36 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/972702
Citazioni
  • ???jsp.display-item.citation.pmc??? 17
  • Scopus 44
  • ???jsp.display-item.citation.isi??? 42
social impact