Metabolic and Skeletal Complications of HIV Infection
The Price of Success
- Caryn G. Morse, MD, MPH;
- Joseph A. Kovacs, MD
- Author Affiliations: National Institute of Allergy and Infectious Diseases–Clinical Center HIV/AIDS Program, Critical Care Medicine Department, NIH Clinical Center, Bethesda, Md.
- Corresponding Author: Joseph A. Kovacs, MD, Critical Care Medicine Department, NIH Clinical Center, Bldg 10, Room 2C145, MSC 1662, Bethesda, MD 20892-1662 (jkovacs{at}nih.gov).
Abstract
Over the past 10 years, in conjunction with the broad availability of potent antiretroviral regimens, the care of human immunodeficiency virus (HIV)–infected patients has shifted from prevention and treatment of opportunistic infections and malignancies to management of the metabolic and related complications associated with HIV infection and its treatment. Metabolic disorders, including lipodystrophy, dyslipidemia, and insulin resistance, occur at a high rate in HIV-infected individuals receiving highly active antiretroviral therapy (HAART). These disorders are associated with increased risk of cardiovascular disease and have become an important cause of morbidity and mortality in HIV-infected patients. Herein, we present the case of a patient with HIV infection who responded well to HAART but developed multiple complications potentially related to this therapy. This article reviews the clinical characteristics of the metabolic and skeletal disturbances observed in HIV infection and discusses strategies for their management.
- KEYWORDS:
- ANTIRETROVIRAL THERAPY, HIGHLY ACTIVE
- BONE DISEASES, METABOLIC
- CARDIOVASCULAR DISEASES
- GRAND ROUNDS AT THE CLINICAL CENTER OF THE NATIONAL INSTITUTES OF HEALTH (GALLIN JI, COOPER DS, EDS)
- HIV INFECTIONS
- INSULIN RESISTANCE
- LIPIDS
- LIPODYSTROPHY
- METABOLIC DISEASES
- OSTEONECROSIS
- PROTEASE INHIBITORS
- SKELETON
