Division of Infectious Diseases, University of Cincinnati College of Medicine, 231 Albert Sabin Way, PO Box 670560, Cincinnati, OH 45267-0560, USA.
Curr Infect Dis Rep. 2009 Jan;11(1):84-92. doi: 10.1007/s11908-009-0012-8.
Although noted early in the HIV epidemic, metabolic abnormalities came to prominence when potent combination antiretroviral therapy was introduced. Complications associated with HIV infection and antiretroviral therapy include cardiovascular disease, lipid disorders, glucose metabolism disorders, adipose tissue disorders, bone metabolism disorders, and lactic acidosis. Metabolic complications have driven the discovery of new agents and classes of antiretrovirals, and have shaped guidelines for the management of HIV infection. However, significant uncertainty remains about pathogenesis and management. Substantial complexity exists in the treatment of these disorders, illustrated by the complex drug-drug interactions between lipid-lowering agents and antiretroviral regimens. Several important new developments include the association of a higher risk of cardiovascular events with the discontinuation of antiretroviral therapy or use of specific drugs like abacavir and didanosine. This article reviews the current understanding of metabolic abnormalities associated with HIV and its treatment.
尽管在艾滋病病毒（HIV）流行早期就已注意到代谢异常，但当强效联合抗逆转录病毒疗法问世后，这些异常才受到重视。与 HIV 感染和抗逆转录病毒治疗相关的并发症包括心血管疾病、血脂异常、糖代谢紊乱、脂肪组织紊乱、骨代谢紊乱和乳酸性酸中毒。代谢并发症推动了新药物和抗逆转录病毒药物类别的发现，并为 HIV 感染的管理制定了指南。然而，发病机制和管理方面仍存在很大的不确定性。这些疾病的治疗存在很大的复杂性，降脂药物和抗逆转录病毒方案之间复杂的药物相互作用就说明了这一点。一些重要的新进展包括，停止抗逆转录病毒治疗或使用阿巴卡韦和地达诺辛等特定药物与心血管事件风险增加之间存在关联。本文综述了目前对 HIV 及其治疗相关代谢异常的认识。
