Articles producció científica> Medicina i Cirurgia

Drug therapies for HIV- related metabolic disorders

  • Identification data

    Identifier: imarina:5130922
    Authors:
    Lamarca K, García Sarasola A, Vidal F, Domingo P
    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 regar
  • Others:

    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
    Link to the original source: https://www.tandfonline.com/doi/full/10.1080/14656566.2016.1187133?scroll=top&needAccess=true
    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
    Article's DOI: 10.1080/14656566.2016.1187133
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2016
    Publication Type: Journal Publications
  • Keywords:

    Medicine (Miscellaneous),Pharmacology,Pharmacology & Pharmacy,Pharmacology (Medical)
    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
    Saúde coletiva
    Pharmacology (medical)
    Pharmacology & pharmacy
    Pharmacology
    Medicine (miscellaneous)
    Medicina iii
    Medicina ii
    Medicina i
    General medicine
    Farmacia
    Ciências biológicas ii
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