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抗逆转录病毒疗法对人类免疫缺陷病毒感染患者脂质代谢的影响:新旧药物

Impact of antiretroviral therapy on lipid metabolism of human immunodeficiency virus-infected patients: Old and new drugs.

作者信息

da Cunha Joel, Maselli Luciana Morganti Ferreira, Stern Ana Carolina Bassi, Spada Celso, Bydlowski Sérgio Paulo

机构信息

Joel da Cunha, Luciana Morganti Ferreira Maselli, Ana Carolina Bassi Stern, Sérgio Paulo Bydlowski, Laboratory of Genetics and Molecular Hematology (LIM31), University of São Paulo Medical School (FMUSP), São Paulo SP 05403-000, Brazil.

出版信息

World J Virol. 2015 May 12;4(2):56-77. doi: 10.5501/wjv.v4.i2.56.

Abstract

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.

摘要

对于感染人类免疫缺陷病毒(HIV)的患者来说,20世纪90年代的标志是高效抗逆转录病毒疗法(HAART)的引入,这为这些患者带来了新的生活前景。事实证明,使用HAART可有效抑制HIV-1的复制,并显著降低死亡率和发病率,从而使HIV-1感染患者的生活质量更高、寿命更长。除了使用各种HAART方案带来的诸多益处外,实验室和临床经验表明,HAART可引发与脂质代谢的代谢并发症相关的严重且相当大的不良反应,其特征为脂肪代谢障碍、胰岛素抵抗、中心性肥胖、血脂异常、心血管疾病风险增加,甚至动脉粥样硬化风险增加。正在研究新药,正在实施新的治疗策略,使用他汀类药物、贝特类药物和肠道胆固醇吸收抑制剂已成为有效的替代方法。饮食和生活方式的改变也显示出了令人满意的效果。

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