Leclercq Pascale, Blanc Myriam
Centre d'information et de soins de l'immunodeficience humaine, hôpital Albert-Michallon, 38043 Grenoble Cedex 09.
Rev Prat. 2006 May 15;56(9):987-94.
Life expectancy of HIV-infected patients has improved considerably with HAART. However long term use of HAART is linked with lipodystrophy syndrom (subcutaneous lipoatrophy and central fat accumulation) associated with dyslipemia (hypoHDL, hyperLDL and hypertriglyceridemia) and insulin resistance. It is also linked with mitochondrial toxicity clinically expressed by chronic fatigue syndrom and premature aging. The induced metabolic syndrom has cardiovascular consequences and myocardial infarction is the cause of 7% of the HIV-infected deaths in 2000. Assessment of these complications should be done at least every year. Treatment options concern antiretroviral therapy with the search for the least toxic drug (but with equal antiviral efficacy), symptomatic treatment (statin, fibrates, thiazolidinediones, metformin) and lifestyle modifications (first of all, stopping cigarette smoking!)
高效抗逆转录病毒疗法（HAART）使HIV感染患者的预期寿命有了显著提高。然而，长期使用HAART与脂肪代谢障碍综合征（皮下脂肪萎缩和中心性脂肪堆积）有关，该综合征伴有血脂异常（低高密度脂蛋白、高低密度脂蛋白和高甘油三酯血症）和胰岛素抵抗。它还与线粒体毒性有关，临床表现为慢性疲劳综合征和早衰。所引发的代谢综合征会产生心血管方面的后果，2000年，心肌梗死是7%的HIV感染者死亡的原因。对这些并发症的评估应至少每年进行一次。治疗选择包括寻找毒性最小（但抗病毒疗效相同）的抗逆转录病毒疗法、对症治疗（他汀类药物、贝特类药物、噻唑烷二酮类药物、二甲双胍）以及生活方式的改变（首先是戒烟！）
