Uurlings F, Moutschen M
CHU Sart Tilman, Liège, Belgique.
Rev Med Liege. 2007 Nov;62(11):669-74.
Prolonged utilization of some antiretroviral drugs in patients infected by HIV can lead to the outbreak of a lipodystrophy syndrome. This syndrome is characterized by modification of fats corporal repartition, sometimes associated with metabolic disturbancies (dyslipemia and insulin resistance). Two antiretroviral classes are implicated in the pathophysiology of this syndrome, namely protease inhibitors (PIs) and nucleoside reverse transcriptase inhibitors (NRTIs). The PIs rather influence the differentiation of adipose tissue with its secretion. They are more often associated with visceral adiposity, insulin resistance and dyslipemia. The mitochondrial toxicity of the NRTIs is more frequently responsible for adipose tissue loss at the periphery. Other factors in relation to the patient influence the severity of this syndrome. Several therapeutic options are to be considered both when taking care of the patients suffering from this syndrome and when new patients are to be treated.
在感染HIV的患者中长期使用某些抗逆转录病毒药物可能导致脂肪代谢障碍综合征的爆发。该综合征的特征是身体脂肪分布改变,有时伴有代谢紊乱(血脂异常和胰岛素抵抗)。两类抗逆转录病毒药物与该综合征的病理生理机制有关,即蛋白酶抑制剂(PIs)和核苷类逆转录酶抑制剂(NRTIs)。蛋白酶抑制剂主要影响脂肪组织的分化及其分泌。它们更常与内脏肥胖、胰岛素抵抗和血脂异常相关。核苷类逆转录酶抑制剂的线粒体毒性更常导致外周脂肪组织减少。与患者相关的其他因素会影响该综合征的严重程度。在照顾患有该综合征的患者以及治疗新患者时,都应考虑几种治疗选择。