人类免疫缺陷病毒感染中肥胖和脂肪增生的识别与管理实践综述
Practical Review of Recognition and Management of Obesity and Lipohypertrophy in Human Immunodeficiency Virus Infection.
作者信息
Lake Jordan E, Stanley Takara L, Apovian Caroline M, Bhasin Shalendar, Brown Todd T, Capeau Jaqueline, Currier Judith S, Dube Michael P, Falutz Julian, Grinspoon Steven K, Guaraldi Giovanni, Martinez Esteban, McComsey Grace A, Sattler Fred R, Erlandson Kristine M
机构信息
Department of Medicine, University of Texas Health Science Center at Houston.
Department of Pediatrics, Harvard University School of Medicine and.
出版信息
Clin Infect Dis. 2017 May 15;64(10):1422-1429. doi: 10.1093/cid/cix178.
BACKGROUND
Obesity and lipohypertrophy are common in treated human immunodeficiency virus (HIV) infection and contribute to morbidity and mortality among HIV-infected adults on antiretroviral therapy (ART).
METHODS
We present a consensus opinion on the diagnosis, clinical consequences, and treatment of excess adiposity in adults with treated HIV infection.
RESULTS
Obesity and lipohypertrophy commonly occur among HIV-infected adults on ART and may have overlapping pathophysiologies and/or synergistic metabolic consequences. Traditional, HIV-specific, and ART-specific risk factors all contribute. The metabolic and inflammatory consequences of excess adiposity are critical drivers of non-AIDS events in this population. Although promising treatment strategies exist, further research is needed to better understand the pathophysiology and optimal treatment of obesity and lipohypertrophy in the modern ART era.
CONCLUSIONS
Both generalized obesity and lipohypertrophy are prevalent among HIV-infected persons on ART. Aggressive diagnosis and management are key to the prevention and treatment of end-organ disease in this population and critical to the present and future health of HIV-infected persons.
背景
肥胖和脂肪增生在接受治疗的人类免疫缺陷病毒（HIV）感染中很常见，并导致接受抗逆转录病毒治疗（ART）的HIV感染成年人发病和死亡。
方法
我们针对接受治疗的HIV感染成年人体内肥胖症的诊断、临床后果及治疗提出了一项共识意见。
结果
肥胖和脂肪增生在接受ART治疗的HIV感染成年人中普遍存在，可能具有重叠的病理生理学和/或协同的代谢后果。传统、HIV特异性和ART特异性风险因素均有影响。肥胖症的代谢和炎症后果是该人群非艾滋病事件的关键驱动因素。尽管存在有前景的治疗策略，但仍需要进一步研究，以更好地了解现代ART时代肥胖和脂肪增生的病理生理学及最佳治疗方法。
结论
全身性肥胖和脂肪增生在接受ART治疗的HIV感染者中普遍存在。积极的诊断和管理是预防和治疗该人群终末器官疾病的关键，对HIV感染者当前和未来的健康至关重要。
Zotero 插件