Pathophysiology and Clinical Management of Dyslipidemia in People Living with HIV: Sailing through Rough Seas

被引:3
作者
Papantoniou, Eleni [1 ]
Arvanitakis, Konstantinos [2 ,3 ]
Markakis, Konstantinos [1 ]
Papadakos, Stavros P. [4 ]
Tsachouridou, Olga [1 ]
Popovic, Djordje S. [5 ,6 ]
Germanidis, Georgios [2 ,3 ]
Koufakis, Theocharis [7 ]
Kotsa, Kalliopi [8 ,9 ]
机构
[1] AHEPA Univ Hosp, Aristotle Univ Thessaloniki, Dept Internal Med 1, Thessaloniki 54636, Greece
[2] AHEPA Univ Hosp, Aristotle Univ Thessaloniki, Dept Internal Med 1, Div Gastroenterol & Hepatol, Thessaloniki 54636, Greece
[3] Aristotle Univ Thessaloniki, Fac Hlth Sci, Sch Med, Basic & Translat Res Unit,Special Unit Biomed Res, Thessaloniki 54636, Greece
[4] Natl & Kapodistrian Univ Athens, Med Sch, Dept Pathol 1, Athens 11527, Greece
[5] Clin Ctr Vojvodina, Clin Endocrinol Diabet & Metab Disorders, Novi Sad 21137, Serbia
[6] Univ Novi Sad, Med Fac, Novi Sad 21000, Serbia
[7] Aristotle Univ Thessaloniki, Hippokrat Gen Hosp, Propedeut Dept Internal Med 2, Thessaloniki 54642, Greece
[8] Aristotle Univ Thessaloniki, Div Endocrinol, 1 St Kiriakidi St, Thessaloniki 54636, Greece
[9] Aristotle Univ Thessaloniki, AHEPA Univ Hosp, Med Sch, Dept Internal Med 1,Metab & Diabet Ctr, 1 St Kiriakidi St, Thessaloniki 54636, Greece
来源
LIFE-BASEL | 2024年 / 14卷 / 04期
关键词
HIV; dyslipidemia; metabolic syndrome; antiretroviral therapy; switching strategy; HUMAN-IMMUNODEFICIENCY-VIRUS; DENSITY-LIPOPROTEIN-CHOLESTEROL; REVERSE-TRANSCRIPTASE INHIBITORS; C-REACTIVE PROTEIN; POLYUNSATURATED FATTY-ACIDS; COA REDUCTASE INHIBITORS; INFECTED PATIENTS; ANTIRETROVIRAL-THERAPY; LIPID PROFILES; MITOCHONDRIAL-DNA;
D O I
10.3390/life14040449
中图分类号
Q [生物科学];
学科分类号
07 ; 0710 ; 09 ;
摘要
Infections with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) represent one of the greatest health burdens worldwide. The complex pathophysiological pathways that link highly active antiretroviral therapy (HAART) and HIV infection per se with dyslipidemia make the management of lipid disorders and the subsequent increase in cardiovascular risk essential for the treatment of people living with HIV (PLHIV). Amongst HAART regimens, darunavir and atazanavir, tenofovir disoproxil fumarate, nevirapine, rilpivirine, and especially integrase inhibitors have demonstrated the most favorable lipid profile, emerging as sustainable options in HAART substitution. To this day, statins remain the cornerstone pharmacotherapy for dyslipidemia in PLHIV, although important drug-drug interactions with different HAART agents should be taken into account upon treatment initiation. For those intolerant or not meeting therapeutic goals, the addition of ezetimibe, PCSK9, bempedoic acid, fibrates, or fish oils should also be considered. This review summarizes the current literature on the multifactorial etiology and intricate pathophysiology of hyperlipidemia in PLHIV, with an emphasis on the role of different HAART agents, while also providing valuable insights into potential switching strategies and therapeutic options.
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