Author, as appears in the article.: Lamarca K, García Sarasola A, Vidal F, Domingo P
Department: Medicina i Cirurgia
URV's Author/s: Vidal Marsal, Francisco
Keywords: Virus-infected patients Statins Receiving protease inhibitors Metformin Metabolic complications Medicine-association Lipodystrophy syndrome Lipid-lowering therapy Fibrates Fenofibrate improves Ezetimibe Dipeptidyl peptidase-4 inhibitors Coronary-heart-disease Combination antiretroviral therapy Cardiovascular risk Antiretroviral therapy metformin metabolic complications fibrates ezetimibe combination antiretroviral therapy cardiovascular risk
Abstract: INTRODUCTION: Human immunodeficiency virus (HIV) has become a chronic disease often associated with dyslipidaemia and insulin resistance. Combination antiretroviral therapy (cART) may contribute to metabolic disturbances, eventually leading to increased cardiovascular disease (CVR) in this population. Escalating interventions to decrease CVR include promoting a healthy lifestyle, such as quitting smoking, diet and regular exercise. If they do not achieve the goals, a change of cART should be considered, followed by or used concomitantly with the use of chemical therapies. AREAS COVERED: The aim of this article is to review the available drug therapies for the treatment of metabolic disorders in HIV-infected patients and to examine their safety and effectiveness in this population. A review of the literature was conducted, highlighting the most relevant articles. EXPERT OPINION: Switching strategies can be useful but its expected benefit is not high. Therefore, chemical intervention is often needed. Statins have been proven to reduce CVR in the general population and in HIV-infected patients. Simvastatin is contraindicated in patients treated with boosted PI due to interactions; atorvastatin is safe at submaximal dose and needs close monitoring, while pravastatin lacks lipid-lowering potency, and rosuvastatin and pitavastatin are safe. Ezetimibe and fibrates are also safe and effective in HIV-infected patients and can be used in combination with statins. The management of glucose homeostatic disorders in HIV-infected patients follows the same guidelines as in the general population. However, there are specific considerations with respect to the interactions of particular medications with cART. When drug therapy is needed, metformin is the first-line drug. Decisions regarding second- and third-line drugs should be carefully individualized.
Thematic Areas: Saúde coletiva Pharmacology (medical) Pharmacology & pharmacy Pharmacology Medicine (miscellaneous) Medicina iii Medicina ii Medicina i General medicine Farmacia Ciências biológicas ii
licence for use: https://creativecommons.org/licenses/by/3.0/es/
Author's mail: francesc.vidal@urv.cat
Author identifier: 0000-0002-6692-6186
Record's date: 2024-09-07
Papper version: info:eu-repo/semantics/acceptedVersion
Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
Papper original source: Expert Opinion On Pharmacotherapy. 17 (10): 1327-1338
APA: Lamarca K, García Sarasola A, Vidal F, Domingo P (2016). Drug therapies for HIV- related metabolic disorders. Expert Opinion On Pharmacotherapy, 17(10), 1327-1338. DOI: 10.1080/14656566.2016.1187133
Entity: Universitat Rovira i Virgili
Journal publication year: 2016
Publication Type: Journal Publications
Repositori URV