Review Article

Medical Progress

Cardiovascular Risk and Body-Fat Abnormalities in HIV-Infected Adults

Steven Grinspoon, M.D., and Andrew Carr, M.D.

N Engl J Med 2005; 352:48-62January 6, 2005

Article

Metabolic complications, including dyslipidemia, insulin resistance, and altered fat distribution (loss of subcutaneous fat and a relative increase in central fat), are common in adults infected with the human immunodeficiency virus (HIV) who are receiving highly active antiretroviral therapy (HAART). These complications may increase these patients' risk of cardiovascular disease. In this review, we discuss progress in the understanding of pathogenetic mechanisms of cardiovascular risk in this population and the development of treatment strategies.

Body-Fat Abnormalities

Abnormalities in body composition have been reported in 40 to 50 percent of ambulatory HIV-infected patients1-3; the proportion is greater in those receiving combination antiretroviral therapy. Prevalence rates vary widely, from 11 to 83 percent, in cross-sectional studies.4,5 Lipoatrophy rates may be even higher,6 depending on the characteristics of the cohort (sex, age, and possibly race), the type and duration of antiretroviral therapies, the criteria for changes in body composition, and the comparison population. Definitions of clinically significant loss of subcutaneous fat and gain in truncal fat have not yet been established. A preliminary case definition based on data obtained by dual-energy x-ray absorptiometry and computed tomography (CT) was validated in a prospective study but is not yet recommended for use in clinical practice.7

Subcutaneous lipoatrophy and relative or absolute accumulation of central fat may occur in HIV-infected patients. Subcutaneous lipoatrophy is most noticeable in the face, limbs, and buttocks but can also occur in the trunk.8 Central fat accumulation, when present, most often represents the accumulation of visceral fat. Total abdominal fat accumulation may vary and may occur independently of peripheral fat loss.6 Fat accumulation may also be found within the breasts and over the dorsocervical spine (resulting in a “buffalo hump”), in lipomata (Figure 1Figure 1Lipoatrophy and Fat Accumulation in HIV-Infected Adults.), and within the muscle and liver.

Prospective studies investigating body composition in patients starting antiretroviral treatment for the first time9,10 have demonstrated initial increases in limb fat during the first few months of therapy, followed by a progressive decline during the ensuing three years; in one study, the decline was estimated to be 14 percent per year among white men receiving regimens containing stavudine or zidovudine with lamivudine and either a protease inhibitor or nonnucleoside reverse-transcriptase inhibitor (Figure 1F).9 In contrast, truncal fat increases initially and then remains stable during the ensuing two to three years, resulting in relative central adiposity. Changes in limb and central fat masses are clinically evident in 20 to 35 percent of patients after approximately 12 to 24 months of combination antiretroviral therapy.11,12

Risk Factors and Pathogenesis

The type, duration, and current use or nonuse of antiretroviral therapy are strongly associated with the severity of lipoatrophy. Combination therapy based on the use of two nucleoside analogue reverse-transcriptase inhibitors and a protease inhibitor is especially strongly associated with severe lipoatrophy.9,10

Protease inhibitors may induce lipoatrophy by inhibiting sterol regulatory enhancer–binding protein 1 (SREBP1)–mediated activation of the heterodimer consisting of adipocyte retinoid X receptor and peroxisome proliferator–activated receptor γ (PPARγ) or related transcription factors such as PPARγ coactivator 1.13,14 In vitro studies have demonstrated that protease inhibitors can inhibit lipogenesis and adipocyte differentiation,15 stimulate lipolysis,16 and impair SREBP1 nuclear localization.17

The nucleoside analogue linked most strongly to lipoatrophy is stavudine, particularly when used in combination with didanosine.9,10 Lipoatrophy associated with nucleoside analogues may be due in part to mitochondrial injury resulting from inhibition of mitochondrial DNA polymerase γ within adipocytes18 and depletion of mitochondrial DNA,19 although the extent and specificity of this effect remain unknown. Nucleoside analogues can inhibit adipogenesis and adipocyte differentiation,20 promote lipolysis,21 and exert synergistic toxic effects with those of protease inhibitors in vitro and in vivo.22

Older age, lower body weight before therapy, prior diagnosis of the acquired immunodeficiency syndrome (AIDS), and a lower nadir CD4+ cell count are associated with lipoatrophy. Central fat accumulation may be more common among women than among men.23 Storage of increased circulating fatty acids, impaired fatty acid oxidation, or both may contribute to increased intramyocellular lipid content, hepatic steatosis, and insulin resistance.24-26 Changes in body composition have been reported in a limited number of patients who have never received antiretroviral therapy,1 but most changes occur in response to highly active antiretroviral therapy, when the viral load is markedly diminished.

Assessment

Given the loss of limb fat observed in several prospective studies,9,10 annual assessment of body fat is recommended for adults who begin combination antiretroviral therapy that includes two nucleoside analogues or a protease inhibitor, as well as for any patients who switch antiretroviral agents. Dual-energy x-ray absorptiometry is useful for assessing fat in the limbs over time.9,10,27 Anthropometric measurements of truncal and limb fat, including measurement of waist, hip, and thigh circumferences, may provide additional information about cardiovascular risk.28 CT scanning provides information about abdominal subcutaneous and visceral fat, but it is associated with radiation exposure and should not be used clinically for this purpose. No technique has been validated for the assessment of facial lipoatrophy.

Dyslipidemia

Prevalence

Friis-Møller et al., reporting the results of a large cross-sectional study,29 noted hypercholesterolemia (total cholesterol level, more than 240 mg per deciliter [6.2 mmol per liter]) in 27 percent of subjects receiving combination therapy that included a protease inhibitor, 23 percent receiving a nonnucleoside reverse-transcriptase inhibitor, and 10 percent receiving only nucleoside reverse-transcriptase inhibitors, as compared with 8 percent of previously untreated subjects. The corresponding percentages for hypertriglyceridemia (triglyceride level, more than 200 mg per deciliter [2.3 mmol per liter]) were 40, 32, and 23 percent, as compared with 15 percent among previously untreated subjects.29 Low levels of high-density lipoprotein (HDL) cholesterol (less than 35 mg per deciliter [0.9 mmol per liter]) were reported in 27, 19, and 25 percent of the subjects, respectively, as compared with 26 percent of those who were previously untreated.29 Among patients with evidence of body-fat abnormalities, 57 percent had triglyceride levels above 200 mg per deciliter, and 46 percent had HDL cholesterol levels below 35 mg per deciliter, as compared with 9 and 17 percent of healthy subjects matched for age and body-mass index from the Framingham Offspring Study cohort.28 For cholesterol levels above 200 mg per deciliter (5.2 mmol per liter), the prevalence rate in the HIV-infected group was 57 percent, as compared with 42 percent in the Framingham control group. Prevalence rates vary according to the specific antiretroviral agents used within each class (discussed below).

Longitudinal assessment of patients with HIV seroconversion suggests that there are decreases in total, HDL, and low-density lipoprotein (LDL) cholesterol at the time of infection, before treatment. With the initiation of HAART, total and LDL cholesterol increase to preinfection levels, but low HDL levels persist.30

Pathogenesis

Hypertriglyceridemia in association with low HDL and LDL cholesterol levels was commonly observed in HIV-infected patients before the era of HAART.31 Early studies suggested that contributing factors were increased apolipoprotein E levels, increased hepatic synthesis of very-low-density lipoprotein, and decreased clearance of triglycerides (Figure 2Figure 2Potential Mechanisms for Metabolic Abnormalities in HIV-Infected Patients Receiving Highly Active Antiretroviral Therapy.).31-33 Dyslipidemia may also be due in part to the effects of viral infection, acute-phase reactants, and circulating cytokines, including interferon-α.34

The specific effects of thymidine analogues on lipid turnover have not been determined,35 although it is known that stavudine-based, but not tenofovir-based, antiretroviral therapy is associated with early and statistically significant increases in triglyceride and total cholesterol levels.36 HDL cholesterol levels may improve among patients who switch from a regimen based on a protease inhibitor to a regimen based on other types of drugs.37

Individual protease inhibitors, most notably ritonavir, can increase hepatic triglyceride synthesis and plasma triglyceride levels.38 A newer protease inhibitor, atazanavir, does not appear to have this effect.39 Protease inhibitors also tend to increase total cholesterol levels, but this effect also varies among the individual drugs in this class.40 Alterations in apolipoprotein B occur in patients receiving combination therapy (with a nucleoside analogue and a protease inhibitor): notably, there is an increase in small, dense LDL 2; an increase in apolipoprotein B; and a shift toward triglyceride-rich very-low-density lipoprotein.41 HIV protease inhibitors also decrease proteasomal degradation of nascent lipoprotein B in vitro.42 In addition, the levels of lipoprotein particles containing apolipoprotein C-III and apolipoprotein E increase in protease-inhibitor-treated patients.43

Assessment

In all HIV-infected adults, fasting lipid levels should be measured annually before antiretroviral therapy is initiated, and within one to two months after any change in the antiretroviral regimen. It is important to determine whether there is a family history of dyslipidemia or diabetes and to assess the patient's use of alcohol and of medications known to alter lipid levels (e.g., estrogen). Whenever possible, the antiretroviral medication least likely to worsen lipid levels should be selected for patients with dyslipidemia. The chief risk associated with markedly increased triglyceride levels is pancreatitis.

Insulin Resistance and Abnormal Glucose Homeostasis

Epidemiology

Hyperinsulinemia, a surrogate measure of insulin resistance, is commonly seen in association with excess truncal fat, loss of fat in the limbs, an increased waist-to-hip ratio, and a buffalo hump. Among HIV-infected adults with lipoatrophy or fat accumulation, diabetes mellitus was seen in 7.0 percent, as compared with 0.5 percent of otherwise healthy control subjects matched for age and body-mass index.28 Impaired glucose tolerance was present in more than 35 percent of HIV-infected subjects as compared with 5 percent of otherwise healthy control subjects matched for age and body-mass index.28 In a longitudinal cohort study, diabetes mellitus was 3.1 times as likely to develop in HIV-infected men receiving combination antiretroviral therapy as it was in control subjects over a three-year period of observation.44 The rate at which impaired glucose tolerance and insulin resistance in HIV-infected adults progress to overt diabetes mellitus is not known.

Pathogenesis

Antiretroviral therapy may lead to altered flux of substrates, including free fatty acids,21 as well as to accumulation of intramyocellular lipid,25 alterations in adipokine levels (e.g., a low level of adiponectin),45 and reduced PPARγ expression in subcutaneous adipocytes13; antiretroviral therapy may also contribute to altered glucose homeostasis (Figure 2). Protease inhibitors (including indinavir, amprenavir, nelfinavir, and ritonavir46-48) have been shown to induce insulin resistance in vitro by reducing glucose transport mediated by glucose transporter 4,46 without affecting postreceptor insulin signaling. The results of clinical studies have suggested that indinavir and lopinavir have short-term adverse effects on insulin sensitivity.49,50 Delayed but long-term effects, possibly related to changes in body composition, may affect insulin sensitivity. Protease inhibitors such as atazanavir and saquinavir may have minimal effects on insulin sensitivity.51,52 Protease inhibitors may also reduce pancreatic beta-cell insulin secretion,53 but insulin resistance is the primary defect. Direct effects of nucleoside analogues on glucose metabolism have not been demonstrated, but such drugs may contribute to insulin resistance indirectly through changes in fat distribution.

Assessment

In HIV-infected patients, fasting glucose levels should be determined before antiretroviral therapy is initiated and should be determined annually as well as within a few weeks after any change in the antiretroviral regimen. Weight, the severity of fat-distribution abnormalities, and medication history should all be assessed, as should the family history, for the presence of diabetes mellitus. Impaired glucose tolerance and insulin resistance are likely to be present for a variable period before overt diabetes mellitus develops. Impaired glucose tolerance and hyperinsulinemia are considered cardiovascular risk factors in adults without HIV infection. Thus, an oral glucose-tolerance test or measurement of the fasting insulin level should be considered in HIV-infected patients with other cardiovascular risk factors or a family history of type 2 diabetes mellitus.

Cardiovascular Disease

Epidemiology

Retrospective analyses designed to estimate the risk of cardiovascular disease in relation to antiretroviral therapy have yielded variable results.54-56 The findings do suggest, however, that the risk of cardiovascular disease may be greater in younger patients than in older patients.57

The largest prospective study of cardiovascular risk with antiretroviral therapy is the Data Collection on Adverse Events of Anti-HIV Drugs (DAD) Study.58 Of 23,468 participants, 126 (0.5 percent) had a first myocardial infarction, an incidence of 3.5 per 1000 person-years. Of these infarctions, 29 percent were fatal, representing 6 percent of all the deaths in the study. There were an additional 77 events related to ischemia, including coronary-artery angioplasty or bypass surgery, ischemic stroke, and carotid endarterectomy.59 The incidence of myocardial infarction or of any ischemic vascular event increased directly with longer exposure to antiretroviral therapy (relative risk, 1.26 [95 percent confidence interval, 1.12 to 1.41] per additional year of exposure; P<0.001) (Figure 3Figure 3Incidence of and Risk Factors for Myocardial Infarction among Persons Receiving Antiretroviral Therapy.). Too few ischemic events occurred to determine the relative risk associated with a specific antiretroviral drug class or with individual drugs. Hypercholesterolemia, older age, smoking, diabetes mellitus, male sex, and a prior history of cardiovascular disease were also associated with an increased risk of myocardial infarction (Figure 3).58 The risk of myocardial infarction in relation to the duration of antiretroviral therapy remained significant but was relatively reduced in analyses that adjusted for increased cholesterol levels, suggesting that metabolic abnormalities induced by antiretroviral therapy contributed to the increased morbidity observed.58

Although the DAD Study Group58 found that the relative risk of cardiovascular disease increased as the duration of antiretroviral therapy increased, the absolute risk of cardiovascular disease will remain low for most patients, except those with multiple other cardiovascular risk factors.60 Overall cardiovascular risk can be estimated with use of standardized equations60 (Table 1Table 1Suggested Cardiovascular and Body-Composition Assessments for Adults Receiving Antiretroviral Therapy. and Supplementary Appendix).

Mechanisms of Cardiovascular Disease

Endothelial dysfunction and reduced flow-mediated dilation in association with increased atherogenic lipoproteins have been reported among HIV-infected adults receiving protease inhibitors.62 Hsue et al. reported increased carotid intima–media thicknesses and increased rates of progression over a one-year period in HIV-infected adults with a mean age of 45 years as compared with age- and sex-matched uninfected controls.63 Increased thickness of the carotid intima–media was associated with traditional risk factors, including hypertension, hypercholesterolemia, and smoking.63 Hypertension is more common in HIV-infected patients treated with protease inhibitors, nonnucleoside reverse transcriptase inhibitors, or both than in patients who have never received antiretroviral therapy and is associated with increased body-mass index among HIV-infected patients.29

The mechanisms of vascular disease in HIV-infected patients are not known but may relate to dyslipidemia, insulin resistance, diabetes mellitus, inflammation, impaired fibrinolysis, factors specific to antiretroviral medications, or combinations of these factors. Increased tissue levels of plasminogen activator and plasminogen-activator inhibitor 1 suggest that fibrinolysis is impaired in HIV-infected patients. Elevations in these substances are associated with hyperinsulinemia, lipodystrophy, and protease-inhibitor therapy64 but have not been specifically linked to vascular disease in this population. High levels of protease inhibitors may promote the formation of atherosclerotic lesions by increasing CD36-dependent cholesterol ester accumulation in macrophages, a scavenger-receptor pathway that is thought to mediate the formation of atherosclerotic lesions.65

Risk Assessment and Treatment Options

Risk-Factor Modification

All potential cardiovascular risk factors, including dyslipidemia, insulin resistance, hypertension, smoking, sedentary lifestyle, weight, and family history, should be assessed. The use of surrogate markers, such as C-reactive protein, to predict vascular disease has not yet been validated in the HIV-infected population. It is recommended that dietary and lifestyle alterations, including appropriate interventions for smoking and hypertension, be initiated first; subsequently, therapy with lipid-lowering medications for hyperlipidemia or changes in antiretroviral therapy can be begun, when clinically possible. Insulin-sensitizing agents are recommended for patients with diabetes mellitus and should be considered for those with marked insulin resistance.

The relative benefits derived from switching antiretroviral regimens and effecting metabolic and lifestyle changes have not been compared directly. Risk-factor modification must balance the risk of progression of HIV disease against the potential risk of progression of cardiovascular disease with long-term maintenance of antiretroviral therapy (Table 1 and Table 2Table 2Estimated Risks of Myocardial Infarction at 10 Years and of AIDS or Death at 3 Years among Men Initiating Highly Active Antiretroviral Therapy, According to Cardiovascular Risks and HIV Disease Status.). Although the risk of cardiovascular disease is increasing among HIV-infected patients, it is still low and is unlikely to outweigh the substantial benefits of appropriate administration of antiretroviral medications. Cardiovascular risk may be a lesser concern for patients with advanced HIV disease and those with HIV disease that is resistant to antiretroviral drugs. However, in planning risk-modification strategies, clinicians may do well to consider effective antiretroviral agents with the lowest propensity to increase glucose or lipid levels (Table 3Table 3Potential Interventions for Anthropometric and Metabolic Abnormalities in HIV-Infected Patients.).

Lifestyle Modifications

Cigarette smoking is the most important modifiable cardiovascular risk factor among HIV-infected patients. In the DAD Study, more than 50 percent of the enrolled subjects were classified as current or former cigarette smokers, and smoking conferred a greater than twofold risk of myocardial infarction (Figure 3).58 Cessation of smoking is more likely to reduce cardiovascular risk than either the choice of antiretroviral therapy or the use of any lipid-lowering therapy.

Exercise alone, in the form of progressive resistance training, has been shown to reduce overall fat and truncal fat in HIV-infected patients who have increased abdominal girth.73 Combined aerobic and strength programs result in reductions in the waist-to-hip ratio, the amount of visceral fat, and the levels of cholesterol, triglyceride, and LDL cholesterol, in association with a reduction in total fat.74,75 Combined exercise and metformin therapy decreased truncal fat, the waist-to-hip ratio, muscle adiposity, systolic and diastolic blood pressures, and fasting insulin levels more than metformin therapy alone but did not improve lipid levels.76 A reduction in muscle adiposity proved to be a strong predictor of improved insulin resistance.77 In contrast, the effect of conditioning programs on patients with predominant, severe lipoatrophy is unknown, and such programs may be inappropriate or potentially harmful for this group of patients.

Limited data on the effects of dietary modification are available for the HIV-infected population. Use of National Cholesterol Education Program guidelines for reduction of cholesterol and triglyceride levels in HIV-infected patients reduced these levels by 11 percent and 21 percent, respectively, whereas gemfibrozil reduced cholesterol by 32 percent and triglycerides by 57 percent.66 However, use of the guidelines often failed to normalize lipid levels. Barrios et al. demonstrated that a lipid-lowering diet in HIV-infected patients with combined hyperlipidemia led to 10 percent and 23 percent reductions in total cholesterol and triglyceride levels, respectively, after six months.78 Thus, though not always effective, dietary counseling is prudent in HIV-infected patients who are at increased cardiovascular risk.

Metabolic Interventions

Lipid-Lowering Drugs

In general, a hydroxymethylglutaryl–coenzyme A reductase inhibitor (statin) should be used to treat isolated hypercholesterolemia, and a fibrate should be used to treat isolated hypertriglyceridemia. Combined statin–fibrate therapy can be considered when the response is incomplete, provided that there is appropriate safety monitoring, including periodic measurement of creatine kinase and aminotransferase levels. In one study, gemfibrozil therapy in conjunction with a low-fat diet lowered triglyceride levels by 18 percent over a 16-week period, but it did not lower cholesterol levels.67 In contrast, pravastatin combined with dietary advice reduced cholesterol levels by 17 percent (a significant reduction) over a 24-week period, without changing triglyceride levels.68 An open-label study reported that atorvastatin lowered cholesterol and triglyceride levels,66 suggesting that the drug may be beneficial in adults with combined hyperlipidemia. In an open-label study involving 113 adults with hypertriglyceridemia who were receiving HAART, fibrates (bezafibrate, fenofibrate, and gemfibrozil) were more beneficial than statins in decreasing triglycerides (a reduction of 41 percent vs. 35 percent) but were less beneficial in reducing total cholesterol (22 percent vs. 25 percent) over a 12-month period.69 Fenofibrate alone resulted in a 40 percent reduction in triglycerides and a 14 percent reduction in cholesterol in a three-month study of HIV-infected adults with hypertriglyceridemia.79 Until more specific recommendations become available, National Cholesterol Education Program guidelines should be used when lipid-lowering therapy is initiated in HIV-infected patients. Drug interactions, especially between specific protease inhibitors and statins, should always be considered (Table 3).80

Insulin-Sensitizing Drugs

In HIV-infected adults with central obesity and hyperinsulinemia, metformin (500 mg twice daily) improved insulin sensitivity and decreased visceral adiposity, levels of cardiovascular risk markers (tissue plasminogen activator and plasminogen-activator inhibitor 1), and blood pressure.81,82 Metformin, like all biguanides, can theoretically precipitate lactic acidosis; but this adverse interaction has not been reported.82-84 Greater reductions in visceral fat may be seen with larger doses of metformin84 but may increase the risk of toxic effects. Metformin may also be useful as an initial treatment for type 2 diabetes mellitus in HIV-infected adults who have increased truncal adiposity and are overweight, but lactate levels and hepatic and renal function must be monitored. Initiation of metformin therapy may be associated with gastrointestinal upset, but this effect is usually transient. Use of metformin should be avoided in patients with creatinine levels above 1.5 mg per deciliter (132.6 μmol per liter), increased aminotransferase levels, or hyperlactatemia. It is unknown whether the use of metformin in HIV-infected patients with impaired glucose tolerance prevents the development of diabetes mellitus. Because metformin may reduce subcutaneous fat,85 its use should be avoided in patients with clinically significant lipoatrophy who have no increase in truncal adiposity.

Thiazolidinediones are antidiabetes drugs with PPARγ-agonist properties that increase subcutaneous fat in persons with diabetes and adults with congenital lipoatrophy.86 Three randomized studies have investigated the effects of thiazolidinediones in HIV-infected adults. In a 24-week study of rosiglitazone, no benefit in patients with lipoatrophy was observed with respect to total or subcutaneous fat, but there was improvement in hepatic steatosis.87 By contrast, in a 12-week study of rosiglitazone in HIV-infected patients with insulin resistance and fat atrophy there was a 24 percent improvement in fat in the legs, as assessed by CT. The study also found statistically significant improvements in lipoatrophy, as assessed by physicians and by the patients themselves.88 A larger, 48-week study in adults receiving a protease inhibitor, a thymidine nucleoside analogue, or both reported that rosiglitazone did not improve limb fat or total fat distribution.89 However, all three studies found beneficial effects on insulin resistance, possibly as a result of increased adiponectin levels.87-89 Two small, nonrandomized studies of thiazolidinediones found increased amounts of abdominal subcutaneous fat in HIV-infected patients who had insulin resistance.90,91 Rosiglitazone was associated with increased total cholesterol and LDL cholesterol levels in all three of the randomized studies87-89 and with increased triglyceride levels in one of them.89 Rosiglitazone cannot be recommended for general treatment of lipoatrophy at this time, but it may be useful in patients with insulin resistance.

Growth Hormone

Growth hormone at high doses (e.g., 6 mg per day) appears to be effective in reducing visceral fat, but it also reduces subcutaneous fat and is associated with side effects, including joint swelling, fluid retention, and worsening of glucose tolerance.92 Furthermore, it is expensive. Lower, but nonetheless supraphysiologic, doses of growth hormone may also be effective in reducing visceral fat and may have fewer side effects.93 Growth hormone levels are reduced in HIV-infected men who have excess visceral adiposity, and growth hormone secretagogues (including growth hormone–releasing hormone) may prove useful for increasing growth hormone levels to within the physiologic range and for restoring the distribution of body fat toward normal.94

Surgery and Other Strategies to Restore Body Contours

Injection of various agents has been investigated as therapy for facial lipoatrophy. The most widely used is polylactic acid, a resorbable molecule that promotes collagen formation and appears to improve the appearance of facial soft tissue,95 with few complications. Surgery (excision or liposuction) has been performed on some patients who have marked dorsocervical fat accumulation, although fat may reaccumulate within a few months.

Changes in Antiretroviral Therapy

Cessation of therapy with the thymidine nucleoside analogue stavudine or zidovudine generally leads to substantial improvements in limb fat mass. However, if another drug is not substituted, virologic failure is likely. In one study, virologic control was unaffected two years after stavudine or zidovudine was replaced by abacavir.27 Limb fat mass increased by about 36 percent but remained well below normal levels and was not clearly associated with clinically evident improvement in lipoatrophy. Substitution of thymidine nucleoside analogues has not been shown to improve central adiposity, insulin resistance, or dyslipidemia.27,96

Replacement of a protease inhibitor with nevirapine, efavirenz, or abacavir can effectively reduce total cholesterol,70,71,97,98 LDL cholesterol,97,98 and triglyceride levels71,97 and increase HDL cholesterol levels.98 Limited data suggest that insulin resistance may also improve in response to replacement of a protease inhibitor by nevirapine.71 Protease-inhibitor cessation has not been shown to improve lipoatrophy. In one randomized study, body-fat changes tended to improve six months after a switch from a protease inhibitor to nevirapine.72

Prevention

Few studies have been performed to determine whether strategies such as lifestyle modification, diet, or medications might be used to prevent metabolic and body-composition abnormalities in HIV-infected adults. Furthermore, specific studies have not investigated whether the timing of antiretroviral therapy would effect such changes. Use of the nucleoside analogues abacavir and lamivudine together with the nonnucleoside analogue efavirenz may not result in decreased limb fat for up to three years after the start of treatment.99 Tenofovir combined with lamivudine and efavirenz is associated with less limb fat loss and a better lipid profile than stavudine in a similar combination in patients who have not taken any antiretroviral drugs.36

Conclusions

Metabolic and body-fat abnormalities are common among HIV-infected adults receiving nucleoside-analogue and protease-inhibitor therapy. There is preliminary evidence that suggests that such patients have an increased risk of cardiovascular disease. Diet, lifestyle modification, and use of lipid-lowering and insulin-sensitizing regimens may be useful in specific situations. Clinicians caring for HIV-infected adults should assess cardiovascular risk factors and target risk reduction, though not at the expense of successful treatment of the underlying HIV disease.

Supported in part by funding from the Mary Fisher Clinical AIDS Research and Education Fund (to Dr. Grinspoon) and by grants (R01DK59535 to Dr. Grinspoon and R01HL65953 to Dr. Carr) from the National Institutes of Health.

Dr. Grinspoon reports having received grant support from Amgen and Gilead Pharmaceuticals; having served as a consultant for Bristol-Myers Squibb, Thera Technologies, and Solvay; and having received lecture fees from Serono, Abbott Laboratories, Millennium, GlaxoSmithKline, Praecis Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals, and Auxilium Pharmaceuticals. Dr. Carr reports having served as a consultant for GlaxoSmithKline, Roche, and Abbott Laboratories; having received lecture fees from Boehringer Ingelheim, Bristol-Myers Squibb, GlaxoSmithKline, Abbott Laboratories, Roche, and Merck; and having served on advisory boards for Bayer, Bristol-Myers Squibb, GlaxoSmithKline, and Roche.

We are indebted to Donald Chisholm, M.D., David Cooper, D.Sc., Sara Dolan, N.P., Kathleen Fitch, N.P., Colleen Hadigan, M.D., Polyxeni Koutkia, M.D., Matthew Law, Ph.D., Patrick Mallon, M.D., and Katherine Samaras, Ph.D., for research contributions and to Bridget Canavan for assistance with the preparation of the manuscript.

Source Information

From the Program in Nutritional Metabolism and the Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston (S.G.); and the HIV, Immunology, and Infectious Diseases Clinical Services Unit, St. Vincent's Hospital, Sydney (A.C.).

Address reprint requests to Dr. Grinspoon at the Program in Nutritional Metabolism, Massachusetts General Hospital, 55 Fruit St., LON207, Boston, MA 02114, or at sgrinspoon@partners.org.

References

References

1. 1

   Lichtenstein KA, Ward DJ, Moorman AC, et al. Clinical assessment of HIV-associated lipodystrophy in an ambulatory population. AIDS 2001;15:1389-1398
   CrossRef | Web of Science | Medline

2. 2

   Bernasconi E, Boubaker K, Junghans C, et al. Abnormalities of body fat distribution in HIV-infected persons treated with antiretroviral drugs: the Swiss HIV Cohort Study. J Acquir Immune Defic Syndr 2002;31:50-55
   CrossRef | Web of Science | Medline

3. 3

   Miller J, Carr A, Emery S, et al. HIV lipodystrophy: prevalence, severity and correlates of risk in Australia. HIV Med 2003;4:293-301
   CrossRef | Medline

4. 4

   Carr A, Samaras K, Thorisdottir A, Kaufmann GR, Chisholm DJ, Cooper DA. Diagnosis, prediction, and natural course of HIV-1 protease-inhibitor-associated lipodystrophy, hyperlipidaemia, and diabetes mellitus: a cohort study. Lancet 1999;353:2093-2099
   CrossRef | Web of Science | Medline

5. 5

   Gervasoni C, Ridolfo AL, Trifiro G, et al. Redistribution of body fat in HIV-infected women undergoing combined antiretroviral therapy. AIDS 1999;13:465-471
   CrossRef | Web of Science | Medline

6. 6

   Grunfeld C. Basic science and metabolic disturbances. In: Program and abstracts of the XIV International AIDS Conference, Barcelona, Spain, July 7–12, 2002:81. abstract.
   

7. 7

   Carr A, Emery S, Law M, Puls R, Lundgren JD, Powderly WG. An objective case definition of lipodystrophy in HIV-infected adults: a case-control study. Lancet 2003;361:726-735
   CrossRef | Web of Science | Medline

8. 8

   Carr A, Cooper DA. Lipodystrophy associated with an HIV-protease inhibitor. N Engl J Med 1998;339:1296-1296
   Full Text | Web of Science | Medline

9. 9

   Mallon PW, Miller J, Cooper DA, Carr A. Prospective evaluation of the effects of antiretroviral therapy on body composition in HIV-1-infected men starting therapy. AIDS 2003;17:971-979
   CrossRef | Web of Science | Medline

10. 10

    Dube M, Zackin R, Tebas P, et al. Prospective study of regional body composition in antiretroviral-naive subjects randomized to receive zidovudine + lamivudine or didanosine + stavudine combined with nelfinavir, efavirenz, or both: A5005s, a study of ACTG 384. Antivir Ther 2002:L18.
    

11. 11

    Martinez E, Mocroft A, Garcia-Viejo MA, et al. Risk of lipodystrophy in HIV-1-infected patients treated with protease inhibitors: a prospective cohort study. Lancet 2001;357:592-598
    CrossRef | Web of Science | Medline

12. 12

    Heath KV, Hogg RS, Singer J, Chan KJ, O'Shaughnessy MV, Montaner JS. Antiretroviral treatment patterns and incident HIV-associated morphologic and lipid abnormalities in a population-based cohort. J Acquir Immune Defic Syndr 2002;30:440-447
    CrossRef | Web of Science | Medline

13. 13

    Bastard JP, Caron M, Vidal H, et al. Association between altered expression of adipogenic factor SREBP1 in lipoatrophic adipose tissue from HIV-1-infected patients and abnormal adipocyte differentiation and insulin resistance. Lancet 2002;359:1026-1031
    CrossRef | Web of Science | Medline

14. 14

    Caron M, Auclair M, Vigouroux C, Glorian M, Forest C, Capeau J. The HIV protease inhibitor indinavir impairs sterol regulatory element-binding protein-1 intranuclear localization, inhibits preadipocyte differentiation, and induces insulin resistance. Diabetes 2001;50:1378-1388
    CrossRef | Web of Science | Medline

15. 15

    Dowell P, Flexner C, Kwiterovich PO, Lane MD. Suppression of preadipocyte differentiation and promotion of adipocyte death by HIV protease inhibitors. J Biol Chem 2000;275:41325-41332
    CrossRef | Web of Science | Medline

16. 16

    Lenhard JM, Furfine ES, Jain RG, et al. HIV protease inhibitors block adipogenesis and increase lipolysis in vitro. Antiviral Res 2000;47:121-129
    CrossRef | Web of Science | Medline

17. 17

    Caron M, Auclair M, Sterlingot H, Kornprobst M, Capeau J. Some HIV protease inhibitors alter lamin A/C maturation and stability, SREBP-1 nuclear localization and adipocyte differentiation. AIDS 2003;17:2437-2444
    CrossRef | Web of Science | Medline

18. 18

    Reiss P, Casula M, de Ronde A, Weverling G, Goudsmit J, Lange JM. Greater and more rapid depletion of mitochondrial DNA in blood of patients treated with dual (zidovudine + didanosine or zidovudine + zalcitabine) vs. single (zidovudine) nucleoside reverse transcriptase inhibitors. HIV Med 2004;5:11-14
    CrossRef | Web of Science | Medline

19. 19

    Nolan D, Hammond E, Martin A, et al. Mitochondrial DNA depletion and morphologic changes in adipocytes associated with nucleoside reverse transcriptase inhibitor therapy. AIDS 2003;17:1329-1338
    CrossRef | Web of Science | Medline

20. 20

    Pace CS, Martin AM, Hammond EL, Mamotte CD, Nolan DA, Mallal SA. Mitochondrial proliferation, DNA depletion and adipocyte differentiation in subcutaneous adipose tissue of HIV-positive HAART recipients. Antivir Ther 2003;8:323-331
    Web of Science | Medline

21. 21

    Hadigan C, Borgonha S, Rabe J, Young V, Grinspoon S. Increased rates of lipolysis among human immunodeficiency virus-infected men receiving highly active antiretroviral therapy. Metabolism 2002;51:1143-1147
    CrossRef | Web of Science | Medline

22. 22

    Roche R, Poizot-Martin I, Yazidi CM, et al. Effects of antiretroviral drug combinations on the differentiation of adipocytes. AIDS 2002;16:13-20
    CrossRef | Web of Science | Medline

23. 23

    Galli M, Veglia F, Angarano G, et al. Gender differences in antiretroviral drug-related adipose tissue alterations: women are at higher risk than men and develop particular lipodystrophy patterns. J Acquir Immune Defic Syndr 2003;34:58-61
    CrossRef | Web of Science | Medline

24. 24

    Sutinen J, Hakkinen AM, Westerbacka J, et al. Increased fat accumulation in the liver in HIV-infected patients with antiretroviral therapy-associated lipodystrophy. AIDS 2002;16:2183-2193
    CrossRef | Web of Science | Medline

25. 25

    Gan SK, Samaras K, Thompson CH, et al. Altered myocellular and abdominal fat partitioning predict disturbance in insulin action in HIV protease inhibitor-related lipodystrophy. Diabetes 2002;51:3163-3169
    CrossRef | Web of Science | Medline

26. 26

    Behrens GM, Boerner AR, Weber K, et al. Impaired glucose phosphorylation and transport in skeletal muscle cause insulin resistance in HIV-1-infected patients with lipodystrophy. J Clin Invest 2002;110:1319-1327
    CrossRef | Web of Science | Medline

27. 27

    Martin A, Smith DE, Carr A, et al. Reversibility of lipoatrophy in HIV-infected patients 2 years after switching from a thymidine analogue to abacavir: the MITOX Extension Study. AIDS 2004;18:1029-1036
    CrossRef | Web of Science | Medline

28. 28

    Hadigan C, Meigs JB, Corcoran C, et al. Metabolic abnormalities and cardiovascular disease risk factors in adults with human immunodeficiency virus infection and lipodystrophy. Clin Infect Dis 2001;32:130-139
    CrossRef | Web of Science | Medline

29. 29

    Friis-Moller N, Weber R, Reiss P, et al. Cardiovascular disease risk factors in HIV patients -- association with antiretroviral therapy: results from the DAD study. AIDS 2003;17:1179-1193
    CrossRef | Web of Science | Medline

30. 30

    Riddler SA, Smit E, Cole SR, et al. Impact of HIV infection and HAART on serum lipids in men. JAMA 2003;289:2978-2982
    CrossRef | Web of Science | Medline

31. 31

    Grunfeld C, Pang M, Doerrler W, Shigenaga JK, Jensen P, Feingold KR. Lipids, lipoproteins, triglyceride clearance, and cytokines in human immunodeficiency virus infection and the acquired immunodeficiency syndrome. J Clin Endocrinol Metab 1992;74:1045-1052
    CrossRef | Web of Science | Medline

32. 32

    Hellerstein MK, Grunfeld C, Wu K, et al. Increased de novo hepatic lipogenesis in human immunodeficiency virus infection. J Clin Endocrinol Metab 1993;76:559-565
    CrossRef | Web of Science | Medline

33. 33

    Grunfeld C, Doerrler W, Pang M, Jensen P, Weisgraber KH, Feingold KR. Abnormalities of apolipoprotein E in the acquired immunodeficiency syndrome. J Clin Endocrinol Metab 1997;82:3734-3740
    CrossRef | Web of Science | Medline

34. 34

    Christeff N, Melchior JC, de Truchis P, Perronne C, Gougeon ML. Increased serum interferon alpha in HIV-1 associated lipodystrophy syndrome. Eur J Clin Invest 2002;32:43-50
    CrossRef | Web of Science | Medline

35. 35

    Matthews GV, Moyle GJ, Mandalia S, Bower M, Nelson M, Gazzard BG. Absence of association between individual thymidine analogues or nonnucleoside analogues and lipid abnormalities in HIV-1-infected persons on initial therapy. J Acquir Immune Defic Syndr 2000;24:310-315
    CrossRef | Web of Science | Medline

36. 36

    Gallant JE, Staszewski S, Pozniak AL, et al. Efficacy and safety of tenofovir DF vs stavudine in combination therapy in antiretroviral-naive patients: a 3-year randomized trial. JAMA 2004;292:191-201
    CrossRef | Web of Science | Medline

37. 37

    van der Valk M, Kastelein JJ, Murphy RL, et al. Nevirapine-containing antiretroviral therapy in HIV-1 infected patients results in an anti-atherogenic lipid profile. AIDS 2001;15:2407-2414
    CrossRef | Web of Science | Medline

38. 38

    Lenhard JM, Croom DK, Weiel JE, Winegar DA. HIV protease inhibitors stimulate hepatic triglyceride synthesis. Arterioscler Thromb Vasc Biol 2000;20:2625-2629
    CrossRef | Web of Science | Medline

39. 39

    Murphy RL, Sanne I, Cahn P, et al. Dose-ranging, randomized, clinical trial of atazanavir with lamivudine and stavudine in antiretroviral-naive subjects: 48-week results. AIDS 2003;17:2603-2614
    CrossRef | Web of Science | Medline

40. 40

    Periard D, Telenti A, Sudre P, et al. Atherogenic dyslipidemia in HIV-infected individuals treated with protease inhibitors: the Swiss HIV Cohort Study. Circulation 1999;100:700-705
    Web of Science | Medline

41. 41

    Schmitz M, Michl GM, Walli R, et al. Alterations of apolipoprotein B metabolism in HIV-infected patients with antiretroviral combination therapy. J Acquir Immune Defic Syndr 2001;26:225-235
    CrossRef | Web of Science | Medline

42. 42

    Liang JS, Distler O, Cooper DA, et al. HIV protease inhibitors protect apolipoprotein B from degradation by the proteasome: a potential mechanism for protease inhibitor-induced hyperlipidemia. Nat Med 2001;7:1327-1331
    CrossRef | Web of Science | Medline

43. 43

    Bonnet E, Ruidavets JB, Tuech J, et al. Apoprotein c-III and E-containing lipoparticles are markedly increased in HIV-infected patients treated with protease inhibitors: association with the development of lipodystrophy. J Clin Endocrinol Metab 2001;86:296-302
    CrossRef | Web of Science | Medline

44. 44

    Brown TT, Cole SR, Li X, et al. Prevalence and incidence of pre-diabetes and diabetes in the Multicenter AIDS Cohort Study. In: Proceedings of the 11th Conference on Retroviruses and Opportunistic Infections, San Francisco, February 8–11, 2004:73. abstract.
    

45. 45

    Tong Q, Sankale JL, Hadigan CM, et al. Regulation of adiponectin in human immunodeficiency virus-infected patients: relationship to body composition and metabolic indices. J Clin Endocrinol Metab 2003;88:1559-1564
    CrossRef | Web of Science | Medline

46. 46

    Murata H, Hruz PW, Mueckler M. The mechanism of insulin resistance caused by HIV protease inhibitor therapy. J Biol Chem 2000;275:20251-20254
    CrossRef | Web of Science | Medline

47. 47

    Rudich A, Vanounou S, Riesenberg K, et al. The HIV protease inhibitor nelfinavir induces insulin resistance and increases basal lipolysis in 3T3-L1 adipocytes. Diabetes 2001;50:1425-1431
    CrossRef | Web of Science | Medline

48. 48

    Ben-Romano R, Rudich A, Torok D, et al. Agent and cell-type specificity in the induction of insulin resistance by HIV protease inhibitors. AIDS 2003;17:23-32
    CrossRef | Web of Science | Medline

49. 49

    Noor MA, Seneviratne T, Aweeka FT, et al. Indinavir acutely inhibits insulin-stimulated glucose disposal in humans: a randomized, placebo-controlled study. AIDS 2002;16:F1-F8
    CrossRef | Web of Science | Medline

50. 50

    Lee GA, Seneviratne T, Noor MA, et al. The metabolic effects of lopinavir/ritonavir in HIV-negative men. AIDS 2004;18:641-649
    CrossRef | Web of Science | Medline

51. 51

    Noor MA, Grasela D, Parker RA, et al. The effect of atazanavir vs lopinavir/ritonavir on insulin-stimulated glucose disposal rate in healthy subjects. In: Proceedings of the 11th Conference on Retroviruses and Opportunistic Infections, San Francisco, February 8–11, 2004:702. abstract.
    

52. 52

    Kurowski M, Sternfeld T, Sawyer A, Hill A, Mocklinghoff C. Pharmacokinetic and tolerability profile of twice-daily saquinavir hard gelatin capsules and saquinavir soft gelatin capsules boosted with ritonavir in healthy volunteers. HIV Med 2003;4:94-100
    CrossRef | Medline

53. 53

    Woerle HJ, Mariuz PR, Meyer C, et al. Mechanisms for the deterioration in glucose tolerance associated with HIV protease inhibitor regimens. Diabetes 2003;52:918-925
    CrossRef | Web of Science | Medline

54. 54

    Bozzette SA, Ake CF, Tam HK, Chang SW, Louis TA. Cardiovascular and cerebrovascular events in patients treated for human immunodeficiency virus infection. N Engl J Med 2003;348:702-710
    Full Text | Web of Science | Medline

55. 55

    Klein D, Hurley LB, Quesenberry CP Jr, Sidney S. Do protease inhibitors increase the risk for coronary heart disease in patients with HIV-1 infection? J Acquir Immune Defic Syndr 2002;30:471-477
    CrossRef | Web of Science | Medline

56. 56

    Mary-Krause M, Cotte L, Simon A, Partisani M, Costagliola D. Increased risk of myocardial infarction with duration of protease inhibitor therapy in HIV-infected men. AIDS 2003;17:2479-2486
    CrossRef | Web of Science | Medline

57. 57

    Currier JS, Taylor A, Boyd F, et al. Coronary heart disease in HIV-infected individuals. J Acquir Immune Defic Syndr 2003;33:506-512
    CrossRef | Web of Science | Medline

58. 58

    The Data Collection on Adverse Events of Anti-HIV Drugs (DAD) Study Group. Combination antiretroviral therapy and the risk of myocardial infarction. N Engl J Med 2003;349:1993-2003[Erratum, N Engl J Med 2004;350:955.]
    Full Text | Web of Science | Medline

59. 59

    d'Arminio A, Sabin CA, Phillips AN, et al. Cardio- and cerebrovascular events in HIV-infected persons. AIDS 2004;18:1811-1817
    CrossRef | Web of Science | Medline

60. 60

    Law MG, D'Arminio Monforte A, Friis-Moller N, et al. Cardio- and cerebrovascular events and predicted rates of myocardial infarction in the D:A:D: study. In: Proceedings of the 11th Conference on Retroviruses and Opportunistic Infections, San Francisco, February 8–11, 2004:737. abstract.
    

61. 61

    Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation 1998;97:1837-1847
    Web of Science | Medline

62. 62

    Stein JH, Klein MA, Bellehumeur JL, et al. Use of human immunodeficiency virus-1 protease inhibitors is associated with atherogenic lipoprotein changes and endothelial dysfunction. Circulation 2001;104:257-262
    Web of Science | Medline

63. 63

    Hsue PY, Lo JC, Franklin A, et al. Progression of atherosclerosis as assessed by carotid intima-media thickness in patients with HIV infection. Circulation 2004;109:1603-1608
    CrossRef | Web of Science | Medline

64. 64

    Koppel K, Bratt G, Schulman S, Bylund H, Sandstrom E. Hypofibrinolytic state in HIV-1-infected patients treated with protease inhibitor-containing highly active antiretroviral therapy. J Acquir Immune Defic Syndr 2002;29:441-449
    CrossRef | Web of Science | Medline

65. 65

    Dressman J, Kincer J, Matveev SV, et al. HIV protease inhibitors promote atherosclerotic lesion formation independent of dyslipidemia by increasing CD36-dependent cholesteryl ester accumulation in macrophages. J Clin Invest 2003;111:389-397
    Web of Science | Medline

66. 66

    Henry K, Melroe H, Huebesch J, Hermundson J, Simpson J. Atorvastatin and gemfibrozil for protease-inhibitor-related lipid abnormalities. Lancet 1998;352:1031-1032
    CrossRef | Web of Science | Medline

67. 67

    Miller J, Brown D, Amin J, et al. A randomized, double-blind study of gemfibrozil for the treatment of protease inhibitor-associated hypertriglyceridaemia. AIDS 2002;16:2195-2200
    CrossRef | Web of Science | Medline

68. 68

    Moyle GJ, Lloyd M, Reynolds B, Baldwin C, Mandalia S, Gazzard BG. Dietary advice with or without pravastatin for the management of hypercholesterolaemia associated with protease inhibitor therapy. AIDS 2001;15:1503-1508
    CrossRef | Web of Science | Medline

69. 69

    Calza L, Manfredi R, Chiodo F. Statins and fibrates for the treatment of hyperlipidaemia in HIV-infected patients receiving HAART. AIDS 2003;17:851-859
    CrossRef | Web of Science | Medline

70. 70

    Martinez E, Arnaiz JA, Podzamczer D, et al. Substitution of nevirapine, efavirenz, or abacavir for protease inhibitors in patients with human immunodeficiency virus infection. N Engl J Med 2003;349:1036-1046
    Full Text | Web of Science | Medline

71. 71

    Martinez E, Conget I, Lozano L, Casamitjana R, Gatell JM. Reversion of metabolic abnormalities after switching from HIV-1 protease inhibitors to nevirapine. AIDS 1999;13:805-810
    CrossRef | Web of Science | Medline

72. 72

    Barreiro P, Soriano V, Blanco F, Casimiro C, de la Cruz JJ, Gonzalez-Lahoz J. Risks and benefits of replacing protease inhibitors by nevirapine in HIV-infected subjects under long-term successful triple combination therapy. AIDS 2000;14:807-812
    CrossRef | Web of Science | Medline

73. 73

    Roubenoff R, Schmitz H, Bairos L, et al. Reduction of abdominal obesity in lipodystrophy associated with human immunodeficiency virus infection by means of diet and exercise: case report and proof of principle. Clin Infect Dis 2002;34:390-393
    CrossRef | Web of Science | Medline

74. 74

    Jones SP, Doran DA, Leatt PB, Maher B, Pirmohamed M. Short-term exercise training improves body composition and hyperlipidaemia in HIV-positive individuals with lipodystrophy. AIDS 2001;15:2049-2051
    CrossRef | Web of Science | Medline

75. 75

    Thoni GJ, Fedou C, Brun JF, et al. Reduction of fat accumulation and lipid disorders by individualized light aerobic training in human immunodeficiency virus infected patients with lipodystrophy and/or dyslipidemia. Diabetes Metab 2002;28:397-404
    Web of Science | Medline

76. 76

    Driscoll SD, Meininger GE, Lareau MT, et al. Effects of exercise training and metformin on body composition and cardiovascular indices in HIV-infected patients. AIDS 2004;18:465-473
    CrossRef | Web of Science | Medline

77. 77

    Driscoll SD, Meininger GE, Ljungquist K, et al. Differential effects of metformin and exercise on muscle adiposity and metabolic indices in human immunodeficiency virus-infected patients. J Clin Endocrinol Metab 2004;89:2171-2178
    CrossRef | Web of Science | Medline

78. 78

    Barrios A, Blanco F, Garcia-Benayas T, et al. Effect of dietary intervention on highly active antiretroviral therapy-related dyslipemia. AIDS 2002;16:2079-2081
    CrossRef | Web of Science | Medline

79. 79

    Badiou S, Merle De Boever C, Dupuy AM, Baillat V, Cristol JP, Reynes J. Fenofibrate improves the atherogenic lipid profile and enhances LDL resistance to oxidation in HIV-positive adults. Atherosclerosis 2004;172:273-279
    CrossRef | Web of Science | Medline

80. 80

    Fichtenbaum CJ, Gerber JG, Rosenkranz SL, et al. Pharmacokinetic interactions between protease inhibitors and statins in HIV seronegative volunteers: ACTG Study A5047. AIDS 2002;16:569-577
    CrossRef | Web of Science | Medline

81. 81

    Hadigan C, Meigs JB, Rabe J, et al. Increased PAI-1 and tPA antigen levels are reduced with metformin therapy in HIV-infected patients with fat redistribution and insulin resistance. J Clin Endocrinol Metab 2001;86:939-943
    CrossRef | Web of Science | Medline

82. 82

    Hadigan C, Corcoran C, Basgoz N, Davis B, Sax P, Grinspoon S. Metformin in the treatment of HIV lipodystrophy syndrome: a randomized controlled trial. JAMA 2000;284:472-477
    CrossRef | Web of Science | Medline

83. 83

    Hadigan C, Rabe J, Grinspoon S. Sustained benefits of metformin therapy on markers of cardiovascular risk in human immunodeficiency virus-infected patients with fat redistribution and insulin resistance. J Clin Endocrinol Metab 2002;87:4611-4615
    CrossRef | Web of Science | Medline

84. 84

    Saint-Marc T, Touraine JL. Effects of metformin on insulin resistance and central adiposity in patients receiving effective protease inhibitor therapy. AIDS 1999;13:1000-1002
    CrossRef | Web of Science | Medline

85. 85

    Martinez E, Domingo P, Ribera E, et al. Effects of metformin or gemfibrozil on the lipodystrophy of HIV-infected patients receiving protease inhibitors. Antivir Ther 2003;8:403-410
    Web of Science | Medline

86. 86

    Arioglu E, Duncan-Morin J, Sebring N, et al. Efficacy and safety of troglitazone in the treatment of lipodystrophy syndromes. Ann Intern Med 2000;133:263-274
    Web of Science | Medline

87. 87

    Sutinen J, Hakkinen AM, Westerbacka J, et al. Rosiglitazone in the treatment of HAART-associated lipodystrophy -- a randomized double-blind placebo-controlled study. Antivir Ther 2003;8:199-207
    Web of Science | Medline

88. 88

    Hadigan C, Yawetz S, Thomas A, Havers F, Sax PE, Grinspoon S. Metabolic effects of rosiglitazone in HIV lipodystrophy: a randomized, controlled trial. Ann Intern Med 2004;140:786-794
    Web of Science | Medline

89. 89

    Carr A, Workman C, Carey D, et al. No effect of rosiglitazone for treatment of HIV-1 lipoatrophy: randomised, double-blind, placebo-controlled trial. Lancet 2004;363:429-438
    CrossRef | Web of Science | Medline

90. 90

    Calmy A, Hirschel B, Hans D, Karsegard VL, Meier CA. Glitazones in lipodystrophy syndrome induced by highly active antiretroviral therapy. AIDS 2003;17:770-772
    CrossRef | Web of Science | Medline

91. 91

    Gelato MC, Mynarcik DC, Quick JL, et al. Improved insulin sensitivity and body fat distribution in HIV-infected patients treated with rosiglitazone: a pilot study. J Acquir Immune Defic Syndr 2002;31:163-170
    CrossRef | Web of Science | Medline

92. 92

    Engelson ES, Glesby MJ, Mendez D, et al. Effect of recombinant human growth hormone in the treatment of visceral fat accumulation in HIV infection. J Acquir Immune Defic Syndr 2002;30:379-391
    Web of Science | Medline

93. 93

    Kotler DP, Muurahainen N, Grunfeld C, et al. Effects of growth hormone on abnormal visceral adipose tissue accumulation and dyslipidemia in HIV-infected patients. J Acquir Immune Defic Syndr 2004;35:239-252
    CrossRef | Web of Science | Medline

94. 94

    Koutkia P, Canavan B, Breu J, Torriani M, Kissko J, Grinspoon S. Growth hormone-releasing hormone in HIV-infected men with lipodystrophy: a randomized, controlled trial. JAMA 2004;292:210-218
    CrossRef | Web of Science | Medline

95. 95

    Moyle GJ, Lysakova L, Brown S, et al. A randomized open label study of immediate versus delayed polylactic acid injections for the cosmetic management of facial lipoatrophy in persons with HIV infection. HIV Med 2004;5:82-87
    CrossRef | Web of Science | Medline

96. 96

    John M, McKinnon EJ, James IR, et al. Randomized, controlled, 48-week study of switching stavudine and/or protease inhibitors to combivir/abacavir to prevent or reverse lipoatrophy in HIV-infected patients. J Acquir Immune Defic Syndr 2003;33:29-33
    CrossRef | Web of Science | Medline

97. 97

    Moyle GJ, Baldwin C, Langroudi B, Mandalia S, Gazzard BG. A 48-week, randomized, open-label comparison of three abacavir-based substitution approaches in the management of dyslipidemia and peripheral lipoatrophy. J Acquir Immune Defic Syndr 2003;33:22-28
    CrossRef | Web of Science | Medline

98. 98

    Negredo E, Ribalta J, Paredes R, et al. Reversal of atherogenic lipoprotein profile in HIV-1 infected patients with lipodystrophy after replacing protease inhibitors by nevirapine. AIDS 2002;16:1383-1389
    CrossRef | Web of Science | Medline

99. 99

    Shlay J, Visnegarwala F, Bartsch GE, et al. Rates of change in body composition among antiretroviral naive HIV-infected patients randomized to a didanosine/stavudine versus abacavir/lamivudine containing regimen in the Flexible Initial Retrovirus Suppressive Therapies (FIRST) Study, CPCRA 058. Antivir Ther 2003;8:L12-L12 abstract.
    Web of Science

Citing Articles (272)

Citing Articles

1. 1

   J Myers, M Rayment, S Sonecha, G Moyle, M Boffito. (2012) Room for manoeuvre when prescribing statins to dyslipidaemic patients on antiretroviral therapy. HIV Medicine 13:3, 190-192
   CrossRef

2. 2

   V Ceperuelo-Mallafré, X Escoté, C Viladés, J Peraire, P Domingo, E Solano, J-J Sirvent, R Pastor, F Tinahones, M Leal, C Richart, J Vendrell, F Vidal, . (2012) Zinc alpha-2 glycoprotein is implicated in dyslipidaemia in HIV-1-infected patients treated with antiretroviral drugs. HIV Medicinen/a-n/a
   CrossRef

3. 3

   S Oswald, H E Meyer zu Schwabedissen, A Nassif, C Modess, Z Desta, E T Ogburn, J Mostertz, M Keiser, J Jia, A Hubeny, A Ulrich, D Runge, M Marinova, D Lütjohann, H K Kroemer, W Siegmund. (2012) Impact of Efavirenz on Intestinal Metabolism and Transport: Insights From an Interaction Study With Ezetimibe in Healthy Volunteers. Clinical Pharmacology & Therapeutics
   CrossRef

4. 4

   Jeroen P. H. van Wijk, Manuel Castro Cabezas. (2012) Hypertriglyceridemia, Metabolic Syndrome, and Cardiovascular Disease in HIV-Infected Patients: Effects of Antiretroviral Therapy and Adipose Tissue Distribution. International Journal of Vascular Medicine 2012, 1-13
   CrossRef

5. 5

   John Palios, Nikolaos P. E. Kadoglou, Stylianos Lampropoulos. (2012) The Pathophysiology of HIV-/HAART-Related Metabolic Syndrome Leading to Cardiovascular Disorders: The Emerging Role of Adipokines. Experimental Diabetes Research 2012, 1-7
   CrossRef

6. 6

   Carlo Torti, Gherardo Mazziotti, Pier Antonio Soldini, Emanuele Focà, Roberto Maroldi, Daria Gotti, Giampiero Carosi, Andrea Giustina. (2011) High prevalence of radiological vertebral fractures in HIV-infected males. Endocrine
   CrossRef

7. 7

   Benjamin Drew Rockett, Mitchel Harris, Saame Raza Shaikh. (2011) High dose of an n-3 polyunsaturated fatty acid diet lowers activity of C57BL/6 mice. Prostaglandins, Leukotrienes and Essential Fatty Acids
   CrossRef

8. 8

   RAFFAELE RAUSO, NICOLA FREDA, VINCENZO PARLATO, GIULIO GHERARDINI, ROBERTO AMORE, GIANPAOLO TARTARO. (2011) Polyacrylamide Gel Injection for Treatment of Human Immunodeficiency Virus-Associated Facial Lipoatrophy: 18 Months Follow-Up. Dermatologic Surgery 37:11, 1584-1589
   CrossRef

9. 9

   Jason V. Baker, Jacqueline Neuhaus, Daniel Duprez, David A. Cooper, Jennifer Hoy, Lewis Kuller, Fiona C. Lampe, Angelike Liappis, Nina Friis-Moller, Jim Otvos, Nicholas I. Paton, Russell Tracy, James D. Neaton. (2011) Inflammation predicts changes in high-density lipoprotein particles and apolipoprotein A1 following initiation of antiretroviral therapy. AIDS 25:17, 2133-2142
   CrossRef

10. 10

    Stacy D. Fisher, Brinder S. Kanda, Tracie L. Miller, Steven E. Lipshultz. (2011) Cardiovascular Disease and Therapeutic Drug-Related Cardiovascular Consequences in HIV-Infected Patients. American Journal Cardiovascular Drugs1
    CrossRef

11. 11

    J. V. Baker, W. K. Henry, P. Patel, T. J. Bush, L. J. Conley, W. J. Mack, E. T. Overton, M. Budoff, J. Hammer, C. C. Carpenter, H. N. Hodis, J. T. Brooks, . (2011) Progression of Carotid Intima-Media Thickness in a Contemporary Human Immunodeficiency Virus Cohort. Clinical Infectious Diseases 53:8, 826-835
    CrossRef

12. 12

    Gabriel O. de la Garza, Ameera F. Ismail, Carryn M. Anderson, Werner W. Wilke, Mohammed M. Milhem, Henry T. Hoffman, John M. Buatti. (2011) Nelfinavir treatment of adenoid cystic carcinoma: A case report. Practical Radiation Oncology
    CrossRef

13. 13

    J.M. Cubero, P. Domingo, M. Sambeat, J. Ordoñez-Llanos, J. Rodriguez-Espinosa, J.L. Sánchez-Quesada, A. Pérez. (2011) Prevalence of Metabolic Syndrome Among Human Immunodeficiency Virus–Infected Subjects Is Widely Influenced by the Diagnostic Criteria. Metabolic Syndrome and Related Disorders 9:5, 345-351
    CrossRef

14. 14

    Alexander L. Berlin. 2011. Physiology, pathophysiology, and aging. , 14-34.
    CrossRef

15. 15

    Sara E. Dolan Looby. (2011) Menopause-Associated Metabolic Manifestations and Symptomatology in HIV Infection: A Brief Review With Research Implications. Journal of the Association of Nurses in AIDS care
    CrossRef

16. 16

    NF Crum-Cianflone, D Krause, D Wessman, S Medina, J Stepenosky, C Brandt, G Boswell. (2011) Fatty liver disease is associated with underlying cardiovascular disease in HIV-infected persons*. HIV Medicine 12:8, 463-471
    CrossRef

17. 17

    Jorge Parra, Joaquín Portilla, Federico Pulido, Rainel Sánchez-de la Rosa, Carlos Alonso-Villaverde, Juan Berenguer, José L. Blanco, Pere Domingo, Fernando Dronda, Carlos Galera, Félix Gutiérrez, José M. Kindelán, Hernando Knobel, Manuel Leal, Jose López-Aldeguer, Ana Mariño, Celia Miralles, José Moltó, Enrique Ortega, José A. Oteo. (2011) Clinical Utility of Maraviroc. Clinical Drug Investigation 31:8, 527-542
    CrossRef

18. 18

    E. Liu, D. Spiegelman, H. Semu, C. Hawkins, G. Chalamilla, A. Aveika, S. Nyamsangia, S. Mehta, D. Mtasiwa, W. Fawzi. (2011) Nutritional Status and Mortality Among HIV-Infected Patients Receiving Antiretroviral Therapy in Tanzania. Journal of Infectious Diseases 204:2, 282-290
    CrossRef

19. 19

    Fukuko Oka, Toshio Naito, Miki Oike, Rino Imai, Mizue Saita, Akihiro Inui, Kazunori Mitsuhashi, Hiroshi Isonuma, Takuro Shimbo. (2011) Correlation between HIV disease and lipid metabolism in antiretroviral-naïve HIV-infected patients in Japan. Journal of Infection and Chemotherapy
    CrossRef

20. 20

    Raffaele Bruno, Paolo Sacchi, Serena Cima, Laura Maiocchi, Savino F.A. Patruno, Catherine Klersy, Giorgio Barbarini, Valentina Zuccaro, Calogero Camma, Gaetano Filice. (2011) Correlation between FIB4, liver stiffness and metabolic parameters in patients with HIV and hepatitis C virus co-infection. Digestive and Liver Disease 43:7, 575-578
    CrossRef

21. 21

    Faidon Magkos, Aoife Brennan, Laura Sweeney, Eun Seok Kang, John Doweiko, Adolf W. Karchmer, Christos S. Mantzoros. (2011) Leptin replacement improves postprandial glycemia and insulin sensitivity in human immunodeficiency virus–infected lipoatrophic men treated with pioglitazone: a pilot study. Metabolism 60:7, 1045-1049
    CrossRef

22. 22

    Frank J Palella, John P Phair. (2011) Cardiovascular disease in HIV infection. Current Opinion in HIV and AIDS 6:4, 266-271
    CrossRef

23. 23

    Anella Yahiaoui, Ellen L. McGough, Joachim G. Voss. (2011) Development of Evidence-Based Exercise Recommendations for Older HIV-Infected Patients. Journal of the Association of Nurses in AIDS care
    CrossRef

24. 24

    Steven Grinspoon, Kathleen Fitch. (2011) Therapy: HIV-associated dyslipidemia: the Heart Positive study. Nature Reviews Endocrinology 7:8, 443-444
    CrossRef

25. 25

    David Dimock, Vijaya Thomas, Anna Cushing, Julia B. Purdy, Carol Worrell, Jeffrey B. Kopp, Rohan Hazra, Colleen Hadigan. (2011) Longitudinal assessment of metabolic abnormalities in adolescents and young adults with HIV-infection acquired perinatally or in early childhood. Metabolism 60:6, 874-880
    CrossRef

26. 26

    Michael P. Dubé, Joseph J. Cadden. (2011) Lipid Metabolism in Treated HIV Infection. Best Practice & Research Clinical Endocrinology & Metabolism 25:3, 429-442
    CrossRef

27. 27

    Faidon Magkos, Christos S. Mantzoros. (2011) Body fat redistribution and metabolic abnormalities in HIV-infected patients on highly active antiretroviral therapy: novel insights into pathophysiology and emerging opportunities for treatment. Metabolism 60:6, 749-753
    CrossRef

28. 28

    Marta Giralt, Pere Domingo, Francesc Villarroya. (2011) Adipose tissue biology and HIV-infection. Best Practice & Research Clinical Endocrinology & Metabolism 25:3, 487-499
    CrossRef

29. 29

    L. Bornard, M. Blay, P.-M. Roger, M. Raucoules-Aimé, M. Carles. (2011) Anesthésie du patient infecté par le VIH. Annales Françaises d'Anesthésie et de Réanimation 30:6, 501-511
    CrossRef

30. 30

    Chiara Giannarelli, Robert S. Klein, Juan J. Badimon. (2011) Cardiovascular implications of HIV-induced dyslipidemia. Atherosclerosis
    CrossRef

31. 31

    Adrian Curran, Esteban Ribera. (2011) From old to new nucleoside reverse transcriptase inhibitors: changes in body fat composition, metabolic parameters and mitochondrial toxicity after the switch from thymidine analogs to tenofovir or abacavir. Expert Opinion on Drug Safety 10:3, 389-406
    CrossRef

32. 32

    Carla M. T. Fourie, Johannes M. Rooyen, Annamarie Kruger, Michael H. Olsen, Jesper Eugen-Olsen, Rudolph Schutte, Aletta E. Schutte. (2011) Soluble Urokinase Plasminogen Activator Receptor (suPAR) is Associated with Metabolic Changes in HIV-1-Infected Africans: A Prospective Study. Inflammation
    CrossRef

33. 33

    Christina G. Fiorenza, Sharon H. Chou, Christos S. Mantzoros. (2011) Lipodystrophy: pathophysiology and advances in treatment. Nature Reviews Endocrinology 7:3, 137-150
    CrossRef

34. 34

    Brian J Wallace, King-Bing Tan, Sarah L Pett, David A Cooper, Steven Kossard, Margot J Whitfeld. (2011) Enfuvirtide injection site reactions: A clinical and histopathological appraisal. Australasian Journal of Dermatology 52:1, 19-26
    CrossRef

35. 35

    Sergi Veloso, Montserrat Olona, Joaquim Peraire, Consuelo Viladés, Pedro Pardo, Pere Domingo, Victor Asensi, Montserrat Broch, Carmen Aguilar, Miguel López-Dupla, Gerard Aragonés, Graciano Garcia-Pardo, Joan-Josep Sirvent, Joan Vendrell, Cristóbal Richart, Francesc Vidal, for the HIV Lipodystrophy St. (2011) No Relationship Between TNF-α Genetic Variants and Combination Antiretroviral Therapy-Related Lipodystrophy Syndrome in HIV Type 1-Infected Patients: A Case-Control Study and a Meta-Analysis. AIDS Research and Human Retroviruses 27:2, 143-152
    CrossRef

36. 36

    Alexandra Mangili, Joseph F. Polak, Lien A. Quach, Jul Gerrior, Christine A. Wanke. (2011) Markers of atherosclerosis and inflammation and mortality in patients with HIV infection. Atherosclerosis 214:2, 468-473
    CrossRef

37. 37

    K. E. Mondy, J. Gottdiener, E. T. Overton, K. Henry, T. Bush, L. Conley, J. Hammer, C. C. Carpenter, E. Kojic, P. Patel, J. T. Brooks, . (2011) High Prevalence of Echocardiographic Abnormalities among HIV-infected Persons in the Era of Highly Active Antiretroviral Therapy. Clinical Infectious Diseases 52:3, 378-386
    CrossRef

38. 38

    A. MacInnes, A. Lazzarin, G. Di Perri, J.G. Sierra-Madero, J. Aberg, J. Heera, N. Rajicic, J. Goodrich, H. Mayer, H. Valdez. (2011) Maraviroc Can Improve Lipid Profiles in Dyslipidemic Patients with HIV: Results from the MERIT Trial. HIV Clinical Trials 12:1, 24-36
    CrossRef

39. 39

    Oluwaseun Falade-Nwulia, Chloe L. Thio. (2011) Liver disease, HIV and aging. Sexual Health 8:4, 512
    CrossRef

40. 40

    Maria Gracia Mateo, Maria del Mar Gutiérrez, Pere Domingo. (2011) Tesamorelin for the treatment of excess abdominal fat in HIV-1-infected patients with lipodystrophy. Expert Review of Endocrinology & Metabolism 6:1, 21-30
    CrossRef

41. 41

    William Chan, Anthony M. Dart. (2011) Vascular stiffness and aging in HIV. Sexual Health 8:4, 474
    CrossRef

42. 42

    Paula Freitas, Davide Carvalho, Selma Souto, Ana Santos, Sandra Xerinda, Rui Marques, Esteban Martinez, António Sarmento, José Medina. (2011) Impact of Lipodystrophy on the prevalence and components of metabolic syndrome in HIV-infected patients. BMC Infectious Diseases 11:1, 246
    CrossRef

43. 43

    Jason V Baker, Jacqueline Neuhaus, Daniel Duprez, Lewis H Kuller, Russell Tracy, Waldo H Belloso, Stephane De Wit, Fraser Drummond, H Clifford Lane, Bruno Ledergerber, Jens Lundgren, Daniel E Nixon, Nicholas I Paton, James D Neaton. (2011) Changes in Inflammatory and Coagulation Biomarkers: A Randomized Comparison of Immediate versus Deferred Antiretroviral Therapy in Patients With HIV Infection. JAIDS Journal of Acquired Immune Deficiency Syndromes 56:1, 36-43
    CrossRef

44. 44

    Sang Hoon Han, Jialun Zhou, Suneeta Saghayam, Sasheela Vanar, Nittaya Phanuphak, Yi-Ming A Chen, Thira Sirisanthana, Somnuek Sungkanuparph, Christopher KC Lee, Sanjay Pujari, Patrick CK Li, Shinichi Oka, Vonthanak Saphonn, Fujie Zhang, Tuti Parwati Merati, Matthew G Law, Jun Yong Choi. (2011) Prevalence of and risk factors for lipodystrophy among HIV-infected patients receiving combined antiretroviral treatment in the Asia-Pacific region: results from the TREAT Asia HIV Observational Database (TAHOD). Endocrine Journal 58:6, 475-484
    CrossRef

45. 45

    Christos S. Mantzoros. (2011) W(h)ither metreleptin for lipodystrophy and the metabolic syndrome?. Endocrine Practice 1:-1, 1-18
    CrossRef

46. 46

    Cristina Giannattasio, Monica Failla, Nicola Squillace, Alberto Dolara, Francesca Cesana, Francesca Sabbatini, Alessandra Bandera, Rita Facchetti, Dario Dozio, Andrea Gori, Giuseppe Mancia. (2010) Ultrasonographic backscatter of the carotid artery wall in patients with HIV infection: A pilot study. Blood Pressure 19:6, 344-350
    CrossRef

47. 47

    Ayako Suzuki, Manal F. Abdelmalek, Aynur Unalp–Arida, Katherine Yates, Arun Sanyal, Cynthia Guy, Anna Mae Diehl. (2010) Regional Anthropometric Measures and Hepatic Fibrosis in Patients With Nonalcoholic Fatty Liver Disease. Clinical Gastroenterology and Hepatology 8:12, 1062-1069
    CrossRef

48. 48

    Jennifer C. Price, Chloe L. Thio. (2010) Liver Disease in the HIV–Infected Individual. Clinical Gastroenterology and Hepatology 8:12, 1002-1012
    CrossRef

49. 49

    Mark A. Boyd, Andrew M. Hill. (2010) Clinical Management of Treatment-Experienced, HIV/AIDS Patients in the Combination Antiretroviral Therapy Era. PharmacoEconomics 28, 17-34
    CrossRef

50. 50

    Pere Domingo, José M Gallego-Escuredo, Joan C Domingo, Maria del Mar Gutiérrez, Maria G Mateo, Irene Fernández, Francesc Vidal, Marta Giralt, Francesc Villarroya. (2010) Serum FGF21 levels are elevated in association with lipodystrophy, insulin resistance and biomarkers of liver injury in HIV-1-infected patients. AIDS 24:17, 2629-2637
    CrossRef

51. 51

    Erdembileg Anuurad, Andrew Bremer, Lars Berglund. (2010) HIV protease inhibitors and obesity. Current Opinion in Endocrinology, Diabetes and Obesity 17:5, 478-485
    CrossRef

52. 52

    Érico Higino de Carvalho, Demócrito de Barros Miranda Filho, Ricardo Arraes de Alencar Ximenes, Maria de Fátima Pessoa Militão de Albuquerque, Heloísa Ramos Lacerda de Melo, Thais Gelenske, Zoraya de Barros Medeiros, Ulisses Montarroyos, Francisco Bandeira. (2010) Prevalence of Hyperapolipoprotein B and Associations with Other Cardiovascular Risk Factors Among Human Immunodeficiency Virus–Infected Patients in Pernambuco, Brazil. Metabolic Syndrome and Related Disorders 8:5, 403-410
    CrossRef

53. 53

    Camille E. Introcaso, Janet M. Hines, Carrie L. Kovarik. (2010) Cutaneous toxicities of antiretroviral therapy for HIV. Journal of the American Academy of Dermatology 63:4, 549-561
    CrossRef

54. 54

    Tracie L Miller, Gabriel Somarriba, E John Orav, Armando J Mendez, Daniela Neri, Natasha Schaefer, Lourdes Forster, Ronald Goldberg, Gwendolyn B Scott, Steven E Lipshultz. (2010) Biomarkers of Vascular Dysfunction in Children Infected With Human Immunodeficiency Virus-1. JAIDS Journal of Acquired Immune Deficiency Syndromes 55:2, 182-188
    CrossRef

55. 55

    Angel H Montes, Eulalia Valle-Garay, Tomas Suarez-Zarracina, Santiago Melon, Esteban Martinez, Jose A Carton, Julio Collazos, Víctor Asensi. (2010) The MMP1 (−16071G/2G) single nucleotide polymorphism associates with the HAART-related lipodystrophic syndrome. AIDS 24:16, 2499-2506
    CrossRef

56. 56

    Kevin Johns, Ramesh Saeedi, G.B. John Mancini, Greg Bondy. (2010) Ankle Brachial Index Screening for Occult Vascular Disease Is Not Useful in HIV-Positive Patients. AIDS Research and Human Retroviruses 26:9, 955-959
    CrossRef

57. 57

    Robin L. Hardwicke, Stanley T. Lewis, Richard M. Grimes. (2010) Evaluation and Pharmacologic Management of the HIV-Infected Patient With Dyslipidemia. Journal of the Association of Nurses in AIDS care 21:5, 429-438
    CrossRef

58. 58

    Vincenzo Lauriola, Roberto Codella, Guido Lattuada, Andrea Caumo, Elena Capitelli, Adriano Lazzarin, Livio Luzi. (2010) Effects of endurance exercise training on metabolic and inflammatory parameters in HIV-1-infected patients with secondary lipodystrophy and diabetes. Sport Sciences for Health 6:1, 23-26
    CrossRef

59. 59

    Marcello Pinti, Milena Nasi, Lara Gibellini, Erika Roat, Sara De Biasi, Linda Bertoncelli, Andrea Cossarizza. (2010) The Role of Mitochondria in HIV Infection and Its Treatment. Journal of Experimental & Clinical Medicine 2:4, 145-155
    CrossRef

60. 60

    Michael P. Dubé, Changyu Shen, Kieren J. Mather, Jeff Waltz, Martha Greenwald, Samir K. Gupta. (2010) Relationship of Body Composition, Metabolic Status, Antiretroviral Use, and HIV Disease Factors to Endothelial Dysfunction in HIV-Infected Subjects. AIDS Research and Human Retroviruses 26:8, 847-854
    CrossRef

61. 61

    Giovanni Guaraldi, Stefano Zona. (2010) From lipodystrophy to cardiovascular disease: new insight into the management of HIV infection. Clinical Lipidology 5:4, 583-593
    CrossRef

62. 62

    J. Sutinen, M. S. Laaksonen, U. A. Walker, B. Setzer, J. Kemppainen, P. Nuutila, H. Yki-Jarvinen. (2010) Skeletal muscle mitochondrial DNA content and aerobic metabolism in patients with antiretroviral therapy-associated lipoatrophy. Journal of Antimicrobial Chemotherapy 65:7, 1497-1504
    CrossRef

63. 63

    Paul A Volberding, Steven G Deeks. (2010) Antiretroviral therapy and management of HIV infection. The Lancet 376:9734, 49-62
    CrossRef

64. 64

    Roy J. Kim, Richard M. Rutstein. (2010) Impact of Antiretroviral Therapy on Growth, Body Composition and Metabolism in Pediatric HIV Patients. Pediatric Drugs 12:3, 187-199
    CrossRef

65. 65

    Peter M. Janiszewski, Travis J. Saunders, Robert Ross. (2010) Breast Volume is an Independent Predictor of Visceral and Ectopic Fat in Premenopausal Women. Obesity 18:6, 1183-1187
    CrossRef

66. 66

    Carl J. Fichtenbaum. (2010) Does Antiretroviral Therapy Increase or Decrease the Risk of Cardiovascular Disease?. Current HIV/AIDS Reports 7:2, 92-98
    CrossRef

67. 67

    Rakesh K. Mishra. (2010) Cardiac Emergencies in Patients with HIV. Emergency Medicine Clinics of North America 28:2, 273-282
    CrossRef

68. 68

    Martine Caron-Debarle, Claire Lagathu, Franck Boccara, Corinne Vigouroux, Jacqueline Capeau. (2010) HIV-associated lipodystrophy: from fat injury to premature aging. Trends in Molecular Medicine 16:5, 218-229
    CrossRef

69. 69

    Tracie L. Miller, Gabriel Somarriba, Daniel D. Kinnamon, Geoffrey A. Weinberg, Lawrence B. Friedman, Gwendolyn B. Scott. (2010) The Effect of a Structured Exercise Program on Nutrition and Fitness Outcomes in Human Immunodeficiency Virus-Infected Children. AIDS Research and Human Retroviruses 26:3, 313-319
    CrossRef

70. 70

    Francesc Villarroya, Pere Domingo, Marta Giralt. (2010) Drug-induced lipotoxicity: Lipodystrophy associated with HIV-1 infection and antiretroviral treatment. Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biology of Lipids 1801:3, 392-399
    CrossRef

71. 71

    Todd T Brown, Shruti H Mehta, Catherine Sutcliffe, Yvonne Higgins, Michael S Torbenson, Richard D Moore, David L Thomas, Mark S Sulkowski. (2010) Hepatic steatosis associated with increased central body fat by dual-energy X-ray absorptiometry and uncontrolled HIV in HIV/hepatitis C co-infected persons. AIDS 24:6, 811-817
    CrossRef

72. 72

    Abdul Hakeem, Sabha Bhatti, Mehmet Cilingiroglu. (2010) The Spectrum of Atherosclerotic Coronary Artery Disease in HIV Patients. Current Atherosclerosis Reports 12:2, 119-124
    CrossRef

73. 73

    Georg MN Behrens, Peter Reiss. (2010) Abacavir and cardiovascular risk. Current Opinion in Infectious Diseases 23:1, 9-14
    CrossRef

74. 74

    Pierfrancesco Grima, Marcello Guido, Antonella Zizza, Roberto Chiavaroli. (2010) Sonographically measured perirenal fat thickness: An early predictor of atherosclerosis in HIV-1-infected patients receiving highly active antiretroviral therapy?. Journal of Clinical UltrasoundNA-NA
    CrossRef

75. 75

    Nico Reinsch, Kathrin Neuhaus, Stefan Esser, Anja Potthoff, Martin Hower, Norbert H. Brockmeyer, Raimund Erbel, Till Neumann. (2010) Prevalence of Cardiac Diastolic Dysfunction in HIV-Infected Patients: Results of the HIV-HEART Study. HIV Clinical Trials 11:3, 156-162
    CrossRef

76. 76

    Carla Maria T. Fourie, Johannes M. Rooyen, Annamarie Kruger, Aletta E. Schutte. (2010) Lipid Abnormalities in a Never-Treated HIV-1 Subtype C-Infected African Population. Lipids 45:1, 73-80
    CrossRef

77. 77

    David Goldberg, Kathleen M. Weber, Jennifer Orsi, Nancy A. Hessol, Gypsyamber D’Souza, D. Heather Watts, Rebecca Schwartz, Chenglong Liu, Marshall Glesby, Pamela Burian, Mardge H. Cohen. (2010) Smoking Cessation Among Women with and at Risk for HIV: Are They Quitting?. Journal of General Internal Medicine 25:1, 39-44
    CrossRef

78. 78

    Trevor Hawkins. (2010) Understanding and managing the adverse effects of antiretroviral therapy. Antiviral Research 85:1, 201-209
    CrossRef

79. 79

    Janet M. Raboud, Christina Diong, Andrew Carr, Steven Grinspoon, Kathleen Mulligan, Jussi Sutinen, William Rozenbaum, Rodrigo B. Cavalcanti, Handan Wand, Dominique Costagliola, Sharon Walmsley. (2010) A Meta-Analysis of Six Placebo-Controlled Trials of Thiazolidinedione Therapy for HIV Lipoatrophy. HIV Clinical Trials 11:1, 39-50
    CrossRef

80. 80

    S. Fillipas, C. L. Cherry, F. Cicuttini, L. Smirneos, A. E. Holland. (2010) The Effects of Exercise Training on Metabolic and Morphological Outcomes for People Living With HIV: A Systematic Review of Randomised Controlled Trials. HIV Clinical Trials 11:5, 270-282
    CrossRef

81. 81

    Michelle M. Estrella, Derek M. Fine. (2010) Screening for Chronic Kidney Disease in HIV-Infected Patients. Advances in Chronic Kidney Disease 17:1, 26-35
    CrossRef

82. 82

    Sang Hoon Han, Bum Sik Chin, Han Sung Lee, Su Jin Jeong, Hee Kyoung Choi, Chang Oh Kim, Jun Yong Choi, Young Goo Song, Hyun Chul Lee, June Myung Kim. (2009) Serum retinol-binding protein 4 correlates with obesity, insulin resistance, and dyslipidemia in HIV-infected subjects receiving highly active antiretroviral therapy. Metabolism 58:11, 1523-1529
    CrossRef

83. 83

    Daniel Zeve, Wei Tang, Jon Graff. (2009) Fighting Fat with Fat: The Expanding Field of Adipose Stem Cells. Cell Stem Cell 5:5, 472-481
    CrossRef

84. 84

    Shamim Hashemi Nejad, Rajesh T. Gandhi, Oliver Freudenreich. (2009) Clozapine Use in HIV-Infected Schizophrenia Patients: A Case-Based Discussion and Review. Psychosomatics 50:6, 626-632
    CrossRef

85. 85

    Erdembileg Anuurad, Alison Semrad, Lars Berglund. (2009) Human Immunodeficiency Virus and Highly Active Antiretroviral Therapy–Associated Metabolic Disorders and Risk Factors for Cardiovascular Disease. Metabolic Syndrome and Related Disorders 7:5, 401-409
    CrossRef

86. 86

    Kristin H Busse, Colleen Hadigan, Cheryl Chairez, Raul M Alfaro, Elizabeth Formentini, Joseph A Kovacs, Scott R Penzak. (2009) Gemfibrozil Concentrations Are Significantly Decreased in the Presence of Lopinavir-Ritonavir. JAIDS Journal of Acquired Immune Deficiency Syndromes 52:2, 235-239
    CrossRef

87. 87

    Peter M. Farrugia, Richard Lucariello, John T. Coppola. (2009) Human Immunodeficiency Virus and Atherosclerosis. Cardiology in Review 17:5, 211-215
    CrossRef

88. 88

    Lana P. Sturm, Rodney D. Cooter, Keith L. Mutimer, John C. Graham, Guy J. Maddern. (2009) A Systematic Review of Permanent and Semipermanent Dermal Fillers for HIV-Associated Facial Lipoatrophy. AIDS Patient Care and STDs 23:9, 699-714
    CrossRef

89. 89

    Jason V Baker, Daniel Duprez, Joshua Rapkin, Katherine Huppler Hullsiek, Harrison Quick, Richard Grimm, James D Neaton, Keith Henry. (2009) Untreated HIV Infection and Large and Small Artery Elasticity. JAIDS Journal of Acquired Immune Deficiency Syndromes 52:1, 25-31
    CrossRef

90. 90

    C Demacq, V B Vasconcellos, A M Marcaccini, R F Gerlach, A A Machado, J E Tanus-Santos. (2009) A genetic polymorphism of matrix metalloproteinase 9 (MMP-9) affects the changes in circulating MMP-9 levels induced by highly active antiretroviral therapy in HIV patients. The Pharmacogenomics Journal 9:4, 265-273
    CrossRef

91. 91

    Jean B. Nachega, Maria Paola Trotta, Mark Nelson, Adriana Ammassari. (2009) Impact of metabolic complications on antiretroviral treatment adherence: Clinical and public health implications. Current HIV/AIDS Reports 6:3, 121-129
    CrossRef

92. 92

    Jaya A. George, Willem D.F. Venter, Hendrick E. Van Deventer, Nigel J. Crowther. (2009) A Longitudinal Study of the Changes in Body Fat and Metabolic Parameters in a South African Population of HIV-Positive Patients Receiving an Antiretroviral Therapeutic Regimen Containing Stavudine. AIDS Research and Human Retroviruses 25:8, 771-781
    CrossRef

93. 93

    Ying Wang, Brian Tomlinson. (2009) Tesamorelin: a synthetic growth hormone-releasing factor analog for the treatment of HIV-associated lipodystrophy. HIV Therapy 3:4, 319-327
    CrossRef

94. 94

    Rosario Rossi, Annachiara Nuzzo, Giovanni Guaraldi, Nicola Squillace, Gabriella Orlando, Roberto Esposito, Antonella Lattanzi, Maria G. Modena. (2009) Metabolic disorders induced by highly active antiretroviral therapy and their relationship with vascular remodeling of the brachial artery in a population of HIV-infected patients. Metabolism 58:7, 927-933
    CrossRef

95. 95

    Jason Y. Kim, Theoklis Zaoutis, Jaclyn Chu, Huaqing Zhao, Richard Rutstein. (2009) Effects of highly active antiretroviral therapy (HAART) on cholesterol in HIV-1 infected children: a retrospective cohort study. Pharmacoepidemiology and Drug Safety 18:7, 589-594
    CrossRef

96. 96

    Xiushui Ren, Marina Trilesskaya, Damon M. Kwan, Kim Nguyen, Richard E. Shaw, Peter Y. Hui. (2009) Comparison of Outcomes Using Bare Metal Versus Drug-Eluting Stents in Coronary Artery Disease Patients With and Without Human Immunodeficiency Virus Infection. The American Journal of Cardiology 104:2, 216-222
    CrossRef

97. 97

    Allison Martin, Sean Emery. (2009) Metabolic disorders and cardiovascular consequences of  HIV infection and antiretroviral  therapy. Expert Review of Clinical Pharmacology 2:4, 381-390
    CrossRef

98. 98

    Sabine Mercier, Ndeye Fatou Ngom Gueye, Amandine Cournil, Annick Fontbonne, Nane Copin, Ibrahima Ndiaye, Anne-Marie Dupuy, Cécile Cames, Papa Salif Sow, Ibra Ndoye, Eric Delaporte, Kirsten Bork Simondon. (2009) Lipodystrophy and Metabolic Disorders in HIV-1-Infected Adults on 4- to 9-Year Antiretroviral Therapy in Senegal: A Case-Control Study. JAIDS Journal of Acquired Immune Deficiency Syndromes 51:2, 224-230
    CrossRef

99. 99

    Junichiro Tohyama, Jeffrey T. Billheimer, Ilia V. Fuki, George H. Rothblat, Daniel J. Rader, John S. Millar. (2009) Effects of nevirapine and efavirenz on HDL cholesterol levels and reverse cholesterol transport in mice. Atherosclerosis 204:2, 418-423
    CrossRef

100. 100

     Richard H Haubrich, Sharon A Riddler, A Gregory DiRienzo, Lauren Komarow, William G Powderly, Karin Klingman, Kevin W Garren, David L Butcher, James F Rooney, David W Haas, John W Mellors, Diane V Havlir. (2009) Metabolic outcomes in a randomized trial of nucleoside, nonnucleoside and protease inhibitor-sparing regimens for initial HIV treatment. AIDS 23:9, 1109-1118
     CrossRef

101. 101

     Guijing Lu, Asha Thomas-Geevarghese, Erdembileg Anuurad, Subhashree Raghavan, Robert Minolfo, Bernard Ormsby, Wahida Karmally, Wafaa M. El-Sadr, Jeanine Albu, Lars Berglund. (2009) Relationship of Postprandial Nonesterified Fatty Acids, Adipokines, and Insulin Across Gender in Human Immunodeficiency Virus–Positive Patients Undergoing Highly Active Antiretroviral Therapy. Metabolic Syndrome and Related Disorders 7:3, 199-204
     CrossRef

102. 102

     Johan van Griensven, Rony Zachariah, Freya Rasschaert, Edi F. Atté, Tony Reid. (2009) Weight evolution in HIV-1 infected women in Rwanda after stavudine substitution due to lipoatrophy: comparison of zidovudine with tenofovir/abacavir. Transactions of the Royal Society of Tropical Medicine and Hygiene 103:6, 613-619
     CrossRef

103. 103

     Enéas M.O. Lima, Danielle M. Gualandro, Pai C. Yu, Isabela de C.B. Giuliano, André C. Marques, Daniela Calderaro, Bruno Caramelli. (2009) Cardiovascular prevention in HIV patients: Results from a successful intervention program. Atherosclerosis 204:1, 229-232
     CrossRef

104. 104

     Fátima Brañas, José Antonio Serra. (2009) Infección por el virus de la inmunodeficiencia humana en el anciano. Revista Española de Geriatría y Gerontología 44:3, 149-154
     CrossRef

105. 105

     Jason V Baker, W Keith Henry, James D Neaton. (2009) The consequences of HIV infection and antiretroviral therapy use for cardiovascular disease risk: shifting paradigms. Current Opinion in HIV and AIDS 4:3, 176-182
     CrossRef

106. 106

     Juan Pedro-Botet. (2009) Infección por el VIH, síndrome metabólico y riesgo cardiovascular. Clínica e Investigación en Arteriosclerosis 21:2, 68-70
     CrossRef

107. 107

     Katherine Samaras. (2009) Prevalence and Pathogenesis of Diabetes Mellitus in HIV-1 Infection Treated With Combined Antiretroviral Therapy. JAIDS Journal of Acquired Immune Deficiency Syndromes 50:5, 499-505
     CrossRef

108. 108

     Marisa Gallego, Rosario Palacios, Daniel Salas, Ana Hidalgo, Francisco Orihuela, Juan Roldán, Mariela Grana, Julián Olalla, Alfonso del Arco, Juan de Dios Colmenero, Manuel Márquez, Jesús Santos. (2009) Prevalencia de factores de riesgo cardiovascular y de síndrome metabólico en una cohorte de pacientes con infección por el virus de la inmunodeficiencia humana del sur de España. Estudio PREGO. Clínica e Investigación en Arteriosclerosis 21:2, 62-67
     CrossRef

109. 109

     (2009) Timing of initiation of antiretroviral therapy in AIDS-free HIV-1-infected patients: a collaborative analysis of 18 HIV cohort studies. The Lancet 373:9672, 1352-1363
     CrossRef

110. 110

     Grace M Aldrovandi, Jane C Lindsey, Denise L Jacobson, Amanda Zadzilka, Elizabeth Sheeran, Jack Moye, Peggy Borum, William A Meyer, Dana S Hardin, Kathleen Mulligan. (2009) Morphologic and metabolic abnormalities in vertically HIV-infected children and youth. AIDS1
     CrossRef

111. 111

     Judith A. Aberg. (2009) Lipid Management in Patients Who Have HIV and Are Receiving HIV Therapy. Endocrinology & Metabolism Clinics of North America 38:1, 207-222
     CrossRef

112. 112

     Giuseppe Barbaro, Gialuca Iacobellis. (2009) Metabolic syndrome associated with HIV and highly active antiretroviral therapy. Current Diabetes Reports 9:1, 37-42
     CrossRef

113. 113

     L. Slama, C. Le Camus, L. Serfaty, G. Pialoux, J. Capeau, S. Gharakhanian. (2009) Metabolic disorders and chronic viral disease: The case of HIV and HCV. Diabetes & Metabolism 35:1, 1-11
     CrossRef

114. 114

     Raaj R. Sankatsing, Ferdinand W. Wit, Martin Vogel, Eric de Groot, Kees Brinkman, Juergen K. Rockstroh, John J.P. Kastelein, Erik S.G. Stroes, Peter Reiss. (2009) Increased carotid intima-media thickness in HIV patients treated with protease inhibitors as compared to non-nucleoside reverse transcriptase inhibitors. Atherosclerosis 202:2, 589-595
     CrossRef

115. 115

     Katherine Samaras, Seng K. Gan, Phillip W. Peake, Andrew Carr, Lesley V. Campbell. (2009) Proinflammatory Markers, Insulin Sensitivity, and Cardiometabolic Risk Factors in Treated HIV Infection. Obesity 17:1, 53-59
     CrossRef

116. 116

     Maud Lemoine, Jacqueline Capeau, Lawrence Serfaty. (2009) PPAR and Liver Injury in HIV-Infected Patients. PPAR Research 2009, 1-7
     CrossRef

117. 117

     Katherine Samaras. (2009) HIV, insulin resistance and cardiovascular disease. Current Cardiovascular Risk Reports 3:1, 59-64
     CrossRef

118. 118

     Martine Caron, Corinne Vigouroux, Jean-Philippe Bastard, Jacqueline Capeau. (2009) Antiretroviral-Related Adipocyte Dysfunction and Lipodystrophy in HIV-Infected Patients: Alteration of the PPARγ-Dependent Pathways. PPAR Research 2009, 1-8
     CrossRef

119. 119

     Marta Giralt, Pere Domingo, Francesc Villarroya. (2009) HIV-1 Infection and the PPARγ-Dependent Control of Adipose Tissue Physiology. PPAR Research 2009, 1-8
     CrossRef

120. 120

     Jussi Sutinen. (2009) The Effects of Thiazolidinediones on Metabolic Complications and Lipodystrophy in HIV-Infected Patients. PPAR Research 2009, 1-15
     CrossRef

121. 121

     Brian O Porter, Kara B Anthony, Jean Shen, Barbara Hahn, Chris E Keh, Frank Maldarelli, William C Blackwelder, Henry Clifford Lane, Joseph A Kovacs, Richard T Davey, Irini Sereti. (2009) Inferiority of IL-2 alone versus IL-2 with HAART in maintaining CD4 T cell counts during HAART interruption: a randomized controlled trial. AIDS 23:2, 203-212
     CrossRef

122. 122

     Cynthia L Gibert, Judith C Shlay, Shweta Sharma, Glenn Bartsch, Grace Peng, Carl Grunfeld. (2009) Racial Differences in Changes of Metabolic Parameters and Body Composition in Antiretroviral Therapy-Naive Persons Initiating Antiretroviral Therapy. JAIDS Journal of Acquired Immune Deficiency Syndromes 50:1, 44-53
     CrossRef

123. 123

     Carl J. Fichtenbaum. (2009) Metabolic abnormalities associated with HIV infection and antiretroviral therapy. Current Infectious Disease Reports 11:1, 84-92
     CrossRef

124. 124

     C. Vellozzi, J. T. Brooks, T. J. Bush, L. J. Conley, K. Henry, C. C. J. Carpenter, E. T. Overton, J. Hammer, K. Wood, S. D. Holmberg, . (2008) The Study to Understand the Natural History of HIV and AIDS in the Era of Effective Therapy (SUN Study). American Journal of Epidemiology 169:5, 642-652
     CrossRef

125. 125

     Fabienne Marcellin, Sylvie Boyer, Camelia Protopopescu, Aissata Dia, Pierre Ongolo-Zogo, Sinata Koulla-Shiro, Séverin-Cécile Abega, Claude Abé, Jean-Paul Moatti, Bruno Spire, Maria Patrizia Carrieri, . (2008) Determinants of unplanned antiretroviral treatment interruptions among people living with HIV in Yaoundé, Cameroon (EVAL survey, ANRS 12-116). Tropical Medicine & International Health 13:12, 1470-1478
     CrossRef

126. 126

     Ana G. Coloma Conde, Maite Álvarez Albarrán, Alejandro Roca-Cusachs Coll, Pere Domingo Pedrol, Mireia Puig Campmany. (2008) Prevalencia de hipertensión arterial y perfil lipídico en pacientes con infección por el virus de la inmunodeficiencia humana. Medicina Clínica 131:18, 681-684
     CrossRef

127. 127

     Andrew Carr, Armin Ritzhaupt, Wei Zhang, Roberto Zajdenverg, Cassy Workman, Jose M Gatell, Pedro Cahn, Ricardo Chaves. (2008) Effects of boosted tipranavir and lopinavir on body composition, insulin sensitivity and adipocytokines in antiretroviral-naive adults. AIDS 22:17, 2313-2321
     CrossRef

128. 128

     Leandro A. Diehl, Bruno A. Fabris, Décio S Barbosa, Eliana C. De Faria, Susana L. Wiechmann, Alexandre J.F. Carrilho. (2008) Metformin Increases HDL3–Cholesterol and Decreases Subcutaneous Truncal Fat in Nondiabetic Patients with HIV-Associated Lipodystrophy. AIDS Patient Care and STDs 22:10, 779-786
     CrossRef

129. 129

     Monika Schöller-Gyüre, Marta Boffito, Anton L Pozniak, Ruud Leemans, Thomas N Kakuda, Brian Woodfall, Veerle Vyncke, Monika Peeters, Kati Vandermeulen, Richard M. W Hoetelmans. (2008) Effects of Different Meal Compositions and Fasted State on the Oral Bioavailability of Etravirine. Pharmacotherapy 28:10, 1215-1222
     CrossRef

130. 130

     J.M. de Miguel Yanes. (2008) Hiperlipidemias secundarias. Clasificaciones. Factores etiopatogénicos. Complicaciones. Valoración diagnóstica. Medicine - Programa de Formación Médica Continuada Acreditado 10:19, 1242-1245
     CrossRef

131. 131

     Warren L. Dinges, S. Robert Witherspoon, Kamel M. Itani, Abhimanyu Garg, Dolores M. Peterson. (2008) Blepharoptosis and External Ophthalmoplegia Associated with Long‐Term Antiretroviral Therapy. Clinical Infectious Diseases 47:6, 845-852
     CrossRef

132. 132

     Henry H. Rowshan, Kristopher Hart, James P. Arnold, Stevan H. Thompson, Dale Baur, Karen Keith, Peter Skidmore. (2008) Treatment of Human Immunodeficiency Virus–Associated Facial Lipodystrophy Syndrome With Dermafat Graft Transfer to the Nasolabial Fold Areas: A Case Report and Review of the Literature. Journal of Oral and Maxillofacial Surgery 66:9, 1932-1938
     CrossRef

133. 133

     Chotikorn Khunnawat, Siddharth Mukerji, Daniel Havlichek, Rabih Touma, George S. Abela. (2008) Cardiovascular Manifestations in Human Immunodeficiency Virus-Infected Patients. The American Journal of Cardiology 102:5, 635-642
     CrossRef

134. 134

     Julian Falutz, Soraya Allas, Jean-Claude Mamputu, Diane Potvin, Donald Kotler, Michael Somero, Daniel Berger, Stephen Brown, Gary Richmond, Jeffrey Fessel, Ralph Turner, Steven Grinspoon. (2008) Long-term safety and effects of tesamorelin, a growth hormone-releasing factor analogue, in HIV patients with abdominal fat accumulation. AIDS 22:14, 1719-1728
     CrossRef

135. 135

     Pablo Tebas. (2008) Insulin Resistance and Diabetes Mellitus Associated With Antiretroviral Use in HIV-Infected Patients: Pathogenesis, Prevention, and Treatment Options. JAIDS Journal of Acquired Immune Deficiency Syndromes 49:Supplement 2, S86-S92
     CrossRef

136. 136

     David Alain Wohl, Todd T Brown. (2008) Management of Morphologic Changes Associated With Antiretroviral Use in HIV-Infected Patients. JAIDS Journal of Acquired Immune Deficiency Syndromes 49:Supplement 2, S93-S100
     CrossRef

137. 137

     Michael P. Dubé, Changyu Shen, Martha Greenwald, Kieren J. Mather. (2008) No Impairment of Endothelial Function or Insulin Sensitivity with 4 Weeks of the HIV Protease Inhibitors Atazanavir or Lopinavir‐Ritonavir in Healthy Subjects without HIV Infection: A Placebo‐Controlled Trial. Clinical Infectious Diseases 47:4, 567-574
     CrossRef

138. 138

     A. C. F. L. Duran, L. B. Almeida, A. A. C. Segurado, P. C. Jaime. (2008) Diet quality of persons living with HIVAIDS on highly active antiretroviral therapy. Journal of Human Nutrition and Dietetics 21:4, 346-350
     CrossRef

139. 139

     Rosario Palacios, Inmaculada Alonso, Ana Hidalgo, Isabel Aguilar, Miguel A. Sánchez, Pedro Valdivielso, Pedro González-Santos, Jesús Santos. (2008) Peripheral Arterial Disease in HIV Patients Older than 50 Years of Age. AIDS Research and Human Retroviruses 24:8, 1043-1046
     CrossRef

140. 140

     Koustubh Ranade, William J Geese, Mustafa Noor, Oliver Flint, Pablo Tebas, Kathleen Mulligan, William Powderly, Steven K Grinspoon, Michael P Dube. (2008) Genetic analysis implicates resistin in HIV lipodystrophy. AIDS 22:13, 1561-1568
     CrossRef

141. 141

     Lawrence A Kingsley, Juliana Cuervo-Rojas, Alvaro Muñoz, Frank J Palella, Wendy Post, Mallory D Witt, Matthew Budoff, Lewis Kuller. (2008) Subclinical coronary atherosclerosis, HIV infection and antiretroviral therapy: Multicenter AIDS Cohort Study. AIDS 22:13, 1589-1599
     CrossRef

142. 142

     A. S. Foulkes, R. Yucel, M. P. Reilly. (2008) Mixed modeling and multiple imputation for unobservable genotype clusters. Statistics in Medicine 27:15, 2784-2801
     CrossRef

143. 143

     Ove Andersen, Jesper Eugen-Olsen, Kristian Kofoed, Johan Iversen, Steen B. Haugaard. (2008) suPAR associates to glucose metabolic aberration during glucose stimulation in HIV-infected patients on HAART. Journal of Infection 57:1, 55-63
     CrossRef

144. 144

     Leonardo Calza, Roberto Manfredi, Daria Pocaterra, Francesco Chiodo. (2008) Risk of premature atherosclerosis and ischemic heart disease associated with HIV infection and antiretroviral therapy. Journal of Infection 57:1, 16-32
     CrossRef

145. 145

     Blai Coll, Anna Cabre, Carlos Alonso-Villaverde, Iolanda Lazaro, Gerard Aragonés, Sandra Parra, Josefa Girona, Lluis Masana. (2008) The fatty acid binding protein-4 (FABP4) is a strong biomarker of metabolic syndrome and lipodystrophy in HIV-infected patients. Atherosclerosis 199:1, 147-153
     CrossRef

146. 146

     Laurence Fardet, Adrien Kettaneh, Kiet-Phong Tiev, Bénédicte Fabre, Cécile Tolédano, Jean Cabane, Antoine Flahault. (2008) Digital photography as an operational tool for assessing corticosteroid-induced lipodystrophy. European Journal of Internal Medicine 19:5, 340-344
     CrossRef

147. 147

     Giuseppe Vittorio L. De Socio, Giustino Parruti, Tiziana Quirino, Elena Ricci, Giuseppe Schillaci, Beatrice Adriani, Patrizia Marconi, Marzia Franzetti, Canio Martinelli, Francesca Vichi, Giovanni Penco, Claudio Sfara, Giordano Madeddu, Paolo Bonfanti. (2008) Identifying HIV patients with an unfavorable cardiovascular risk profile in the clinical practice: Results from the SIMONE study. Journal of Infection 57:1, 33-40
     CrossRef

148. 148

     Rosario Gulizia, Alessandro Vercelli, Cristina Gervasoni, Alessia Uglietti, Massimiliano Ortu, Giovanna Ferraioli, Massimo Galli, Carlo Filice. (2008) Comparability of Echographic and Tomographic Assessments of Body Fat Changes Related to the HIV Associated Adipose Redistribution Syndrome (HARS) in Antiretroviral Treated Patients. Ultrasound in Medicine & Biology 34:7, 1043-1048
     CrossRef

149. 149

     R. A. Bradbury, K. Samaras. (2008) Antiretroviral therapy and the human immunodeficiency virus – improved survival but at what cost?. Diabetes, Obesity and Metabolism 10:6, 441-450
     CrossRef

150. 150

     Graeme Moyle, Jose Gatell, Carlo-Federico Perno, Winai Ratanasuwan, Mauro Schechter, Christos Tsoukas. (2008) Potential for New Antiretrovirals to Address Unmet Needs in the Management of HIV-1 Infection. AIDS Patient Care and STDs 22:6, 459-471
     CrossRef

151. 151

     M. del Mar Gutiérrez Maciá, M. Gracia Mateo García, Francesc Vidal Marsal, Pere Domingo Pedrol. (2008) Toxicogenética del tratamiento antirretroviral (I): lipodistrofia, alteraciones metabólicas y arteriosclerosis. Enfermedades Infecciosas y Microbiología Clínica 26, 18-23
     CrossRef

152. 152

     Maja A Sommerfelt, Birger Sørensen. (2008) Prospects for HIV-1 therapeutic immunisation and vaccination: the potential contribution of peptide immunogens. Expert Opinion on Biological Therapy 8:6, 745-757
     CrossRef

153. 153

     Alain Makinson, Vincent Le Moing, Charles Kouanfack, Christian Laurent, Eric Delaporte. (2008) Safety of stavudine in the treatment of HIV infection with a special focus on resource-limited settings. Expert Opinion on Drug Safety 7:3, 283-293
     CrossRef

154. 154

     Andrew Carr. (2008) Pathogenesis of cardiovascular disease in HIV infection. Current Opinion in HIV and AIDS 3:3, 234-239
     CrossRef

155. 155

     Javier G. Castillo, David H. Adams, Parwis B. Rahmanian, Farzan Filsoufi. (2008) Cirugía cardiovascular en pacientes con VIH: epidemiología, indicaciones actuales y resultados a largo plazo. Revista Española de Cardiología 61:5, 480-486
     CrossRef

156. 156

     James H. Willig, David A. Jackson, Andrew O. Westfall, Jeroan Allison, Pei‐Wen Chang, James Raper, Michael S. Saag, Michael J. Mugavero. (2008) Clinical Inertia in the Management of Low‐Density Lipoprotein Abnormalities in an HIV Clinic. Clinical Infectious Diseases 46:8, 1315-1318
     CrossRef

157. 157

     Kristin E Mondy, Lisa de las Fuentes, Alan Waggoner, Nur F Önen, Coco S Bopp, Sherry Lassa-Claxton, William G Powderly, Victor Dávila-Román, Kevin E Yarasheski. (2008) Insulin resistance predicts endothelial dysfunction and cardiovascular risk in HIV-infected persons on long-term highly active antiretroviral therapy. AIDS 22:7, 849-856
     CrossRef

158. 158

     Iris Schuster, Gilles Jacques Thöni, Stéphane Edérhy, Guillaume Walther, Stéphane Nottin, Agnès Vinet, Franck Boccara, Mohamed Khireddine, Pierre-Marie Girard, Jean-Marc Mauboussin, Isabelle Rouanet, Michel Dauzat, Ariel Cohen, Patrick Messner-Pellenc, Philippe Obert. (2008) Subclinical Cardiac Abnormalities in Human Immunodeficiency Virus–Infected Men Receiving Antiretroviral Therapy. The American Journal of Cardiology 101:8, 1213-1217
     CrossRef

159. 159

     Maria Saumoy, Miguel López-Dupla, Sergi Veloso, Carlos Alonso-Villaverde, Pere Domingo, Montserrat Broch, Merce Miranda, Blai Coll, Amadeu Saurí, Joan Vendrell, Cristóbal Richart, Francesc Vidal. (2008) The IL-6 system in HIV-1-infection and in HAART-related fat redistribution syndromes. AIDS 22:7, 893-896
     CrossRef

160. 160

     Jennifer J Kiser, John G Gerber, Julie A Predhomme, Pamela Wolfe, Devon M Flynn, Dorie W Hoody. (2008) Drug/Drug Interaction Between Lopinavir/Ritonavir and Rosuvastatin in Healthy Volunteers. JAIDS Journal of Acquired Immune Deficiency Syndromes 47:5, 570-578
     CrossRef

161. 161

     Katherine Tassiopoulos, Paige L Williams, George R Seage, Marilyn Crain, James Oleske, John Farley. (2008) Association of Hypercholesterolemia Incidence With Antiretroviral Treatment, Including Protease Inhibitors, Among Perinatally HIV-Infected Children. JAIDS Journal of Acquired Immune Deficiency Syndromes 47:5, 607-614
     CrossRef

162. 162

     Jordi P Guallar, José M Gallego-Escuredo, Joan C Domingo, Marta Alegre, Joan Fontdevila, Esteban Martínez, Emma L Hammond, Pere Domingo, Marta Giralt, Francesc Villarroya. (2008) Differential gene expression indicates that ‘buffalo hump’ is a distinct adipose tissue disturbance in HIV-1-associated lipodystrophy. AIDS 22:5, 575-584
     CrossRef

163. 163

     Eugene Mutimura, Nigel J. Crowther, Aimee Stewart, W. Todd Cade. (2008) The Human Immunodeficiency Virus and the Cardiometabolic Syndrome in the Developing World: An African Perspective. Journal of the CardioMetabolic Syndrome 3:2, 106-110
     CrossRef

164. 164

     Surendra K. Sharma, Tamilarasu Kadhiravan. (2008) Management of the Patient with HIV Disease. Disease-a-Month 54:3, 162-195
     CrossRef

165. 165

     Tanvi S. Sharma, Sarah Messiah, Stacy Fisher, Tracie L. Miller, Steven E. Lipshultz. (2008) Accelerated Cardiovascular Disease and Myocardial Infarction Risk in Patients With the Human Immunodeficiency Virus. Journal of the CardioMetabolic Syndrome 3:2, 93-97
     CrossRef

166. 166

     Dominic N. Reeds. (2008) Metabolic Syndrome Risks of Cardiovascular Disease: Differences Between HIV-Positive and HIV-Negative?. Journal of the CardioMetabolic Syndrome 3:2, 79-82
     CrossRef

167. 167

     A Nguyen, A Calmy, V Schiffer, E Bernasconi, M Battegay, M Opravil, J-M Evison, PE Tarr, P Schmid, T Perneger, B Hirschel, . (2008) Lipodystrophy and weight changes: data from the Swiss HIV Cohort Study, 2000–2006. HIV Medicine 9:3, 142-150
     CrossRef

168. 168

     W. Todd Cade. (2008) Left Ventricular Dysfunction in Human Immunodeficiency Virus Infection. Journal of the CardioMetabolic Syndrome 3:2, 83-87
     CrossRef

169. 169

     Kristin E. Mondy. (2008) Determinants of Endothelial Function in Human Immunodeficiency Virus Infection: A Complex Interplay Among Therapy, Disease, and Host Factors. Journal of the CardioMetabolic Syndrome 3:2, 88-92
     CrossRef

170. 170

     Victor Asensi, Carolina Rego, A Hugo Montes, Julio Collazos, José A. Carton, Mónica G. Castro, Victoria Álvarez, Cristina Fernández, José A. Maradona, Eulalia Valle-Garay. (2008) IL-1β (+3954C/T) polymorphism could protect human immunodeficiency virus (HIV)-infected patients on highly active antiretroviral treatment (HAART) against lipodystrophic syndrome. Genetics in Medicine 10:3, 215-223
     CrossRef

171. 171

     Ove Andersen, Jesper Eugen-Olsen, Kristian Kofoed, Johan Iversen, Steen B. Haugaard. (2008) Soluble urokinase plasminogen activator receptor is a marker of dysmetabolism in HIV-infected patients receiving highly active antiretroviral therapy. Journal of Medical Virology 80:2, 209-216
     CrossRef

172. 172

     JD Lundgren, M Battegay, G Behrens, S De Wit, G Guaraldi, C Katlama, E Martinez, D Nair, WG Powderly, P Reiss, J Sutinen, A Vigano, . (2008) European AIDS Clinical Society (EACS) guidelines on the prevention and management of metabolic diseases in HIV. HIV Medicine 9:2, 72-81
     CrossRef

173. 173

     A. L. Ridolfo, F. Resta, L. Milazzo, I. Caramma, G. Matacena, S. Antinori, M. Galli. (2008) Reversible Posterior Leukoencephalopathy Syndrome in 2 HIV-Infected Patients Receiving Antiretroviral Therapy. Clinical Infectious Diseases 46:2, e19-e22
     CrossRef

174. 174

     Regje ME Blümer, Marit GA van Vonderen, Jussi Sutinen, Elly Hassink, Mariette Ackermans, Michiel A van Agtmael, Hannele Yki-Jarvinen, Sven A Danner, Peter Reiss, Hans P Sauerwein. (2008) Zidovudine/lamivudine contributes to insulin resistance within 3 months of starting combination antiretroviral therapy. AIDS 22:2, 227-236
     CrossRef

175. 175

     Giuseppe Vittorio L. De Socio, Paolo Bonfanti, Elena Ricci, Giancarlo Orofino, Giordano Madeddu, Giovanni Penco, Erika Gianelli, Canio Martinelli, Silvia Carradori, Tiziana Quirino, Giuliano Rizzardini. (2008) Cholesterol levels in HIV–HCV infected patients treated with lopinavir/r: Results from the SCOLTA project. Biomedicine & Pharmacotherapy 62:1, 16-20
     CrossRef

176. 176

     Andrew Carr, Birgit Grund, Jacqueline Neuhaus, Wafaa M El-Sadr, Gregory Grandits, Cynthia Gibert, Ronald J Prineas. (2008) Asymptomatic myocardial ischaemia in HIV-infected adults. AIDS 22:2, 257-267
     CrossRef

177. 177

     Ana Cristina O. Andrade, Ana Marice Ladeia, Eduardo M. Netto, Amanda Mascarenhas, Bruno Cotter, Constance A. Benson, Roberto Badaró. (2008) Cross-Sectional Study of Endothelial Function in HIV-Infected Patients in Brazil. AIDS Research and Human Retroviruses 24:1, 27-33
     CrossRef

178. 178

     Georg MN Behrens. (2008) Treatment options for lipodystrophy in HIV-positive patients. Expert Opinion on Pharmacotherapy 9:1, 39-52
     CrossRef

179. 179

     Falutz, Julian, Allas, Soraya, Blot, Koenraad, Potvin, Diane, Kotler, Donald, Somero, Michael, Berger, Daniel, Brown, Stephen, Richmond, Gary, Fessel, Jeffrey, Turner, Ralph, Grinspoon, Steven, . (2007) Metabolic Effects of a Growth Hormone–Releasing Factor in Patients with HIV. New England Journal of Medicine 357:23, 2359-2370
     Full Text

180. 180

     Blackman, Marc R., . (2007) Manipulation of the Growth Hormone Axis in Patients with HIV Infection. New England Journal of Medicine 357:23, 2397-2399
     Full Text

181. 181

     F Villarroya, P Domingo, M Giralt. (2007) Lipodystrophy in HIV 1-infected patients: lessons for obesity research. International Journal of Obesity 31:12, 1763-1776
     CrossRef

182. 182

     Eugene Mutimura, Aimee Stewart, Paul Rheeder, Nigel John Crowther. (2007) Metabolic Function and the Prevalence of Lipodystrophy in a Population of HIV-Infected African Subjects Receiving Highly Active Antiretroviral Therapy. JAIDS Journal of Acquired Immune Deficiency Syndromes 46:4, 451-455
     CrossRef

183. 183

     Alexandra Scholze, Martin Tepel. (2007) CARDIOVASCULAR AND SURVIVAL PARADOXES IN DIALYSIS PATIENTS: Role of Leptin in Reverse Epidemiology in Chronic Kidney Disease. Seminars in Dialysis 20:6, 534-538
     CrossRef

184. 184

     M Bickel, J Eisen, C Stephan, CM Crespi, T Lutz, S Klauke, TJ Vogl, V Jacobi, OO Yang, S Staszewski, S Zangos. (2007) A standardized, comprehensive magnetic resonance imaging protocol for rapid and precise quantification of HIV-1-associated lipodystrophy. HIV Medicine 8:7, 413-419
     CrossRef

185. 185

     M Caron, M Auclair, B Donadille, V Béréziat, B Guerci, M Laville, H Narbonne, C Bodemer, O Lascols, J Capeau, C Vigouroux. (2007) Human lipodystrophies linked to mutations in A-type lamins and to HIV protease inhibitor therapy are both associated with prelamin A accumulation, oxidative stress and premature cellular senescence. Cell Death and Differentiation 14:10, 1759-1767
     CrossRef

186. 186

     Mireia Arnedo, Patrick Taffé, Roland Sahli, Hansjakob Furrer, Bernard Hirschel, Luigia Elzi, Rainer Weber, Pietro Vernazza, Enos Bernasconi, Roger Darioli, Sven Bergmann, Jacques S. Beckmann, Amalio Telenti, Philip E. Tarr. (2007) Contribution of 20 single nucleotide polymorphisms of 13 genes to dyslipidemia associated with antiretroviral therapy. Pharmacogenetics and Genomics 17:9, 755-764
     CrossRef

187. 187

     María del Mar Gutierrez, Gracia Mateo, Pere Domingo. (2007) Strategies in the treatment of HIV-1-associated adipose redistribution syndromes. Expert Opinion on Pharmacotherapy 8:12, 1871-1884
     CrossRef

188. 188

     Todd T Brown, Haitao Chu, Zhaojie Wang, Frank J Palella, Lawrence Kingsley, Mallory D Witt, Adrian S Dobs. (2007) Longitudinal increases in waist circumference are associated with HIV-serostatus, independent of antiretroviral therapy. AIDS 21:13, 1731-1738
     CrossRef

189. 189

     Michael P Dub??, Lauren Komarow, Kathleen Mulligan, Steven K Grinspoon, Robert A Parker, Gregory K Robbins, Ronenn Roubenoff, Pablo Tebas. (2007) Long-Term Body Fat Outcomes in Antiretroviral-Naive Participants Randomized to Nelfinavir or Efavirenz or Both Plus Dual Nucleosides. JAIDS Journal of Acquired Immune Deficiency Syndromes 45:5, 508-514
     CrossRef

190. 190

     Ove Andersen, Steen B. Pedersen, Birgit Svenstrup, Birgitte R. Hansen, Søren K. Paulsen, Gulla S. Rathje, Bjørn Richelsen, Jens Ole Nielsen, Sten Madsbad, Johan Iversen, Steen B. Haugaard. (2007) Circulating sex hormones and gene expression of subcutaneous adipose tissue oestrogen and alpha-adrenergic receptors in HIV-lipodystrophy: implications for fat distribution. Clinical Endocrinology 67:2, 250-258
     CrossRef

191. 191

     A S Levey, R Atkins, J Coresh, E P Cohen, A J Collins, K-U Eckardt, M E Nahas, B L Jaber, M Jadoul, A Levin, N R Powe, J Rossert, D C Wheeler, N Lameire, G Eknoyan. (2007) Chronic kidney disease as a global public health problem: Approaches and initiatives – a position statement from Kidney Disease Improving Global Outcomes. Kidney International 72:3, 247-259
     CrossRef

192. 192

     Johan van Griensven, Ludwig De Naeyer, Thomas Mushi, Sowaf Ubarijoro, Diane Gashumba, Claire Gazille, Rony Zachariah. (2007) High prevalence of lipoatrophy among patients on stavudine-containing first-line antiretroviral therapy regimens in Rwanda. Transactions of the Royal Society of Tropical Medicine and Hygiene 101:8, 793-798
     CrossRef

193. 193

     Paolo Bonfanti, Cristina Giannattasio, Elena Ricci, Rita Facchetti, Elena Rosella, Marzia Franzetti, Laura Cordier, Luigi Pusterla, Michele Bombelli, Roberto Sega, Tiziana Quirino, Giuseppe Mancia. (2007) HIV and Metabolic Syndrome. JAIDS Journal of Acquired Immune Deficiency Syndromes 45:4, 426-431
     CrossRef

194. 194

     David Alain Wohl. (2007) Considering metabolic issues when initiating HIV therapy. Current HIV/AIDS Reports 4:3, 119-125
     CrossRef

195. 195

     Hernando Knobel, Carlos Jericó, Milagro Montero, María L. Sorli, Manuela Velat, Ana Guelar, Pere Saballs, Juan Pedro-Botet. (2007) Global Cardiovascular Risk in Patients with HIV Infection: Concordance and Differences in Estimates According to Three Risk Equations (Framingham, SCORE, and PROCAM). AIDS Patient Care and STDs 21:7, 452-457
     CrossRef

196. 196

     L. Fardet, A. Flahault, A. Kettaneh, K.P. Tiev, T. Généreau, C. Tolédano, C. Lebbé, J. Cabane. (2007) Corticosteroid-induced clinical adverse events: frequency, risk factors and patient?s opinion. British Journal of Dermatology 157:1, 142-148
     CrossRef

197. 197

     Andrew Carr. (2007) Treatment strategies for HIV lipodystrophy. Current Opinion in HIV and AIDS 2:4, 332-338
     CrossRef

198. 198

     Tisha Joy, Hester M Keogh, Colleen Hadigan, Hang Lee, Sara E Dolan, Kathleen Fitch, James Liebau, Janet Lo, Stine Johnsen, Jane Hubbard, Ellen J Anderson, Steven Grinspoon. (2007) Dietary fat intake and relationship to serum lipid levels in HIV-infected patients with metabolic abnormalities in the HAART era. AIDS 21:12, 1591-1600
     CrossRef

199. 199

     Martin Vogel, Jürgen K Rockstroh. (2007) Hepatotoxicity and liver disease in the context of HIV therapy. Current Opinion in HIV and AIDS 2:4, 306-313
     CrossRef

200. 200

     Virginia A Triant, Steven K Grinspoon. (2007) Vascular dysfunction and cardiovascular complications. Current Opinion in HIV and AIDS 2:4, 299-304
     CrossRef

201. 201

     Sander I van Leuven, Raaj R Sankatsing, Joost N Vermeulen, John JP Kastelein, Peter Reiss, Erik SG Stroes. (2007) Atherosclerotic vascular disease in HIV: it is not just antiretroviral therapy that hurts the heart!. Current Opinion in HIV and AIDS 2:4, 324-331
     CrossRef

202. 202

     Steen B. Haugaard, Ove Andersen, Ian Halsall, Johan Iversen, Charles Nicholas Hales, Stein Madsbad. (2007) Impaired proinsulin secretion before and during oral glucose stimulation in HIV-infected patients who display fat redistribution. Metabolism 56:7, 939-946
     CrossRef

203. 203

     Patrick WG Mallon. (2007) Antiretroviral therapy-induced lipid alterations: in-vitro, animal and human studies. Current Opinion in HIV and AIDS 2:4, 282-292
     CrossRef

204. 204

     Graeme Moyle. (2007) Metabolic Issues Associated With Protease Inhibitors. JAIDS Journal of Acquired Immune Deficiency Syndromes 45:Supplement 1, S19-S26
     CrossRef

205. 205

     Pablo Tebas, Jiameng Zhang, Kevin Yarasheski, Scott Evans, Margaret A Fischl, Abby Shevitz, Judith Feinberg, Ann C Collier, Cecilia Shikuma, Barbara Brizz, Fred Sattler. (2007) Switching to a Protease Inhibitor-Containing, Nucleoside-Sparing Regimen (Lopinavir/Ritonavir Plus Efavirenz) Increases Limb Fat But Raises Serum Lipid Levels. JAIDS Journal of Acquired Immune Deficiency Syndromes 45:2, 193-200
     CrossRef

206. 206

     L. Waters, M. Nelson. (2007) Long-term complications of antiretroviral therapy: lipoatrophy. International Journal of Clinical Practice 61:6, 999-1014
     CrossRef

207. 207

     Evan Wood, Julio S.G Montaner. (2007) When To Initiate HIV Antiretroviral Therapy. JAIDS Journal of Acquired Immune Deficiency Syndromes 45:2, 131-132
     CrossRef

208. 208

     A. Mangili, D. L. Jacobson, J. Gerrior, J. F. Polak, S. L. Gorbach, C. A. Wanke. (2007) Metabolic Syndrome and Subclinical Atherosclerosis in Patients Infected with HIV. Clinical Infectious Diseases 44:10, 1368-1374
     CrossRef

209. 209

     Gianluca Iacobellis, Adriano M. Pellicelli, Arya M. Sharma, Benvenuto Grisorio, Giorgio Barbarini, Giuseppe Barbaro. (2007) Relation of Subepicardial Adipose Tissue to Carotid Intima-Media Thickness in Patients With Human Immunodeficiency Virus. The American Journal of Cardiology 99:10, 1470-1472
     CrossRef

210. 210

     D. E. Gilden, J. M. Kubisiak, D. M. Gilden. (2007) Managing Medicare's HIV Caseload in the Era of Suppressive Therapy. American Journal of Public Health 97:6, 1053-1059
     CrossRef

211. 211

     K. Mondy, E. T. Overton, J. Grubb, S. Tong, W. Seyfried, W. Powderly, K. Yarasheski. (2007) Metabolic Syndrome in HIV-Infected Patients from an Urban, Midwestern US Outpatient Population. Clinical Infectious Diseases 44:5, 726-734
     CrossRef

212. 212

     Vicente Giner, María José Esteban, María José Galindo, Carlos Monteagudo. (2007) Proteinuria persistente en mujer hipertensa infectada por el VIH. Enfermedades Infecciosas y Microbiología Clínica 25:3, 220-221
     CrossRef

213. 213

     Hironori Waki, Peter Tontonoz. (2007) Endocrine Functions of Adipose Tissue. Annual Review of Pathology: Mechanisms of Disease 2:1, 31-56
     CrossRef

214. 214

     Daniel Podzamczer, Elena Ferrer, Pochita Sanchez, Jos?? M Gatell, Manel Crespo, Cesar Fisac, Montse Lonca, Jose Sanz, Jordi Niubo, Sergio Veloso, Josep M Llibre, Pilar Barrufet, Mar??a A Ribas, Esperanza Merino, Esteban Ribera, Javier Mart??nez-Lacasa, Carlos Alonso, Miquel Aranda, Federico Pulido, Juan Berenguer, Antonio Delegido, Juan D Pedreira, Ana L??rida, Rafael Rubio, Luis del R??o. (2007) Less Lipoatrophy and Better Lipid Profile With Abacavir as Compared to Stavudine. JAIDS Journal of Acquired Immune Deficiency Syndromes 44:2, 139-147
     CrossRef

215. 215

     Kristin Mondy, Pablo Tebas. (2007) Cardiovascular Risks of Antiretroviral Therapies. Annual Review of Medicine 58:1, 141-155
     CrossRef

216. 216

     M. Revest, O. Decaux, C. Cazalets, J.-P. Verohye, P. Jégo, B. Grosbois. (2007) Aortites thoraciques infectieuses : implications microbiologiques, physiopathologiques et thérapeutiques. La Revue de Médecine Interne 28:2, 108-115
     CrossRef

217. 217

     Kathleen Mulligan, Yang Yang, David A Wininger, Susan L Koletar, Robert A Parker, Beverly L Alston-Smith, Jeffrey T Schouten, Roger A Fielding, Michael T Basar, Steven Grinspoon. (2007) Effects of metformin and rosiglitazone in HIV-infected patients with hyperinsulinemia and elevated waist/hip ratio. AIDS 21:1, 47-57
     CrossRef

218. 218

     Donald I. Abrams, Starley B. Shade, Paul Couey, Joseph M. McCune, Joan Lo, Peter Bacchetti, Barbara Chang, Lorrie Epling, Teri Liegler, Robert M. Grant. (2007) Dehydroepiandrosterone (DHEA) Effects on HIV Replication and Host Immunity: A Randomized Placebo-Controlled Study. AIDS Research and Human Retroviruses 23:1, 77-85
     CrossRef

219. 219

     Alexandra Mangili, Christine A Wanke. (2006) Dyslipidemia in HIV infection. Future Lipidology 1:6, 719-728
     CrossRef

220. 220

     Marie-Emilienne Diop, Jean-Philippe Bastard, Natacha Meunier, Sandrine Thévenet, Mustapha Maachi, Jacqueline Capeau, Gilles Pialoux, Corinne Vigouroux. (2006) Inappropriately Low Glycated Hemoglobin Values and Hemolysis in HIV-Infected Patients. AIDS Research and Human Retroviruses 22:12, 1242-1247
     CrossRef

221. 221

     A. Mangili, J. Gerrior, A. M. Tang, D. H. O'Leary, J. K. Polak, E. J. Schaefer, S. L. Gorbach, C. A. Wanke. (2006) Risk of Cardiovascular Disease in a Cohort of HIV-Infected Adults: A Study Using Carotid Intima-Media Thickness and Coronary Artery Calcium Score. Clinical Infectious Diseases 43:11, 1482-1489
     CrossRef

222. 222

     Dr Leonardo Calza, Roberto Manfredi, Francesco Chiodo. (2006) Cardiovascular risk associated with antiretroviral therapy in HIV-infected patients. Expert Opinion on Therapeutic Patents 16:11, 1497-1516
     CrossRef

223. 223

     Ellen S. Engelson, Denise Agin, Sonjia Kenya, Galila Werber-Zion, Besa Luty, Jeanine B. Albu, Donald P. Kotler. (2006) Body composition and metabolic effects of a diet and exercise weight loss regimen on obese, HIV-infected women. Metabolism 55:10, 1327-1336
     CrossRef

224. 224

     Eoin Feeney, Eavan Muldoon, William G Powderly. (2006) Management of antiretroviral drug toxicity. Current Opinion in HIV and AIDS 1:5, 430-436
     CrossRef

225. 225

     D. A. Wohl, G. McComsey, P. Tebas, T. T. Brown, M. J. Glesby, D. Reeds, C. Shikuma, K. Mulligan, M. Dube, D. Wininger, J. Huang, M. Revuelta, J. Currier, S. Swindells, C. Fichtenbaum, M. Basar, M. Tungsiripat, W. Meyer, J. Weihe, C. Wanke. (2006) Current Concepts in the Diagnosis and Management of Metabolic Complications of HIV Infection and Its Therapy. Clinical Infectious Diseases 43:5, 645-653
     CrossRef

226. 226

     M Bickel, S Zangos, V Jacobi, T Lutz, G Knecht, F Goebel, S Staszewski, S Klauke. (2006) A randomized, open-label study to compare the effects of two different doses of recombinant human growth hormone on fat reduction and fasting metabolic parameters in HIV-1-infected patients with lipodystrophy. HIV Medicine 7:6, 397-403
     CrossRef

227. 227

     Victor Asensi, Eustaquio Martín-Roces, Julio Collazos, José A. Cartón, José A. Maradona, Ángeles Alonso, Marifé Medina, Jesús M. Aburto, Cristina Fernández, Esteban Martínez. (2006) Association between Physical and Echographic Fat Thickness Assessments and a Lipodystrophy Grading Scale in Lipodystrophic HIV Patients: Practical Implications. AIDS Research and Human Retroviruses 22:9, 830-836
     CrossRef

228. 228

     Raphael B. Merriman. (2006) Nonalcoholic fatty liver disease and HIV infection. Current HIV/AIDS Reports 3:3, 113-117
     CrossRef

229. 229

     Farzan Filsoufi, Sacha P. Salzberg, Kai T. J. von Harbou, Eric Neibart, David H. Adams. (2006) Excellent Outcomes of Cardiac Surgery in Patients Infected with HIV in the Current Era. Clinical Infectious Diseases 43:4, 532-536
     CrossRef

230. 230

     Monia Pacenti, Luisa Barzon, Francesca Favaretto, Karina Fincati, Sara Romano, Gabriella Milan, Roberto Vettor, Giorgio Palù. (2006) Microarray analysis during adipogenesis identifies new genes altered by antiretroviral drugs. AIDS 20:13, 1691-1705
     CrossRef

231. 231

     J CAPEAU, C VIGOUROUX, J MAGRE, O LASCOLS, M CARON, J BASTARD. (2006) Les syndromes lipodystrophiques : des adipopathies congénitales ou acquises. Comptes Rendus Biologies 329:8, 639-652
     CrossRef

232. 232

     Huang, Laurence, Quartin, Andrew, Jones, Denis, Havlir, Diane V., . (2006) Intensive Care of Patients with HIV Infection. New England Journal of Medicine 355:2, 173-181
     Full Text

233. 233

     Leonid Poretsky, David J. Brillon, Stephen Ferrando, Judy Chiu, Martin McElhiney, Andrea Ferenczi, Maria Cristina Irene P. Sison, Ivan Haller, Judith Rabkin. (2006) Endocrine effects of oral dehydroepiandrosterone in men with HIV infection: a prospective, randomized, double-blind, placebo-controlled trial. Metabolism 55:7, 858-870
     CrossRef

234. 234

     Jack A. DeHovitz, Joseph G. Feldman, Susan Holman, Howard Minkoff. (2006) High Sensitivity C-Reactive Protein and Response to Highly Active Antiretroviral Therapy in Women with HIV-1 Infection. JAIDS Journal of Acquired Immune Deficiency Syndromes 42:3, 383-384
     CrossRef

235. 235

     David Rimland, Jodie L. Guest, Isabel Hern??ndez-Ramos, Carlos del Rio, N. Anh Le, W. Virgil Brown. (2006) Antiretroviral Therapy in HIV-Positive Women Is Associated With Increased Apolipoproteins and Total Cholesterol. JAIDS Journal of Acquired Immune Deficiency Syndromes 42:3, 307-313
     CrossRef

236. 236

     Steen B Haugaard. (2006) Toxic metabolic syndrome associated with HAART. Expert Opinion on Drug Metabolism & Toxicology 2:3, 429-445
     CrossRef

237. 237

     Aoife M Brennan, Christos S Mantzoros. (2006) Drug Insight: the role of leptin in human physiology and pathophysiology—emerging clinical applications. Nature Clinical Practice Endocrinology &#38; Metabolism 2:6, 318-327
     CrossRef

238. 238

     Rafik Samuel, Robert Bettiker, Byungse Suh. (2006) Antiretroviral therapy 2006: Pharmacology, applications, and special situations. Archives of Pharmacal Research 29:6, 431-458
     CrossRef

239. 239

     Josep M Llibre, Pere Domingo, Rosario Palacios, Jesús Santos, Maria J Pérez-Elías, Rainel Sánchez-de la Rosa, Celia Miralles, Antonio Antela, Santiago Moreno. (2006) Sustained improvement of dyslipidaemia in HAART-treated patients replacing stavudine with tenofovir. AIDS 20:10, 1407-1414
     CrossRef

240. 240

     C. Alonso-Villaverde, L. Masana. (2006) Sida, antirretrovirales y alteraciones metabólicas complejas. Clínica e Investigación en Arteriosclerosis 18, 2-9
     CrossRef

241. 241

     J. Koeppe, L. Kosmiski. (2006) Apparent Resolution of Type 2 Diabetes Mellitus after Initiation of Potent Antiretroviral Therapy in a Man from Africa with HIV Infection. Clinical Infectious Diseases 42:10, e79-e81
     CrossRef

242. 242

     I. Bodokh, P. Simonet. (2006) Traitement par injections d’acide polylactique (Newfill®) des lipoatrophies faciales chez les malades infectés par le VIH. Annales de Dermatologie et de Vénéréologie 133:5, 429-432
     CrossRef

243. 243

     Paolo Bonfanti, Elena Ricci, Giuseppe de Socio, Daniela Zeme, Silvia Carradori, Giovanni Penco, Giustino Parruti, Carmela Grosso, Giordano Madeddu, Francesca Vichi, Teresa Bini, Canio Martinelli, Sara Melzi, Tiziana Quirino. (2006) Metabolic Syndrome: A Real Threat for HIV-Positive Patients?. JAIDS Journal of Acquired Immune Deficiency Syndromes 42:1, 128-131
     CrossRef

244. 244

     A. Solages, J. A. Vita, D. J. Thornton, J. Murray, T. Heeren, D. E. Craven, C. R. Horsburgh. (2006) Endothelial Function in HIV-Infected Persons. Clinical Infectious Diseases 42:9, 1325-1332
     CrossRef

245. 245

     James C. Moore, Carolyn F. Dennehey, Arash Anavim, Kevin M. Kong, S. Tiong Ong. (2006) Multiple joint effusions associated with high-dose imatinib therapy in a patient with chronic myelogenous leukaemia. European Journal of Haematology 76:5, 444-446
     CrossRef

246. 246

     Marco Floridia, Giovanni Guaraldi, Enrica Tamburrini, Cecilia Tibaldi, Anna Bucceri, Gianfranco Anzidei, Alessandra Meloni, Antonella Vimercati, Cosimo Polizzi, Ernesto Renato Dalle Nogare, Salvatore Alberico, Marina Ravizza. (2006) Lipodystrophy is an independent predictor of hypertriglyceridemia during pregnancy in HIV-infected women. AIDS 20:6, 944-947
     CrossRef

247. 247

     C. Jericó, H. Knobel, M.L. Sorli, M. Montero, A. Guelar, J. Pedro-Botet. (2006) Síndrome metabólico en pacientes con lipodistrofia infectados por el VIH. Clínica e Investigación en Arteriosclerosis 18:2, 51-56
     CrossRef

248. 248

     Teresa García-Benayas, Ana Lucía Rendón, Sonia Rodríguez-Novóa, Ana Barrios, Ivana Maida, Francisco Blanco, Pablo Barreiro, Pablo Rivas, Juan González-Lahoz, Vincent Soriano. (2006) Higher Risk of Hyperglycemia in HIV-Infected Patients Treated with Didanosine Plus Tenofovir. AIDS Research and Human Retroviruses 22:4, 333-337
     CrossRef

249. 249

     Vinaya Simha, Abhimanyu Garg. (2006) Lipodystrophy: lessons in lipid and energy metabolism. Current Opinion in Lipidology 17:2, 162-169
     CrossRef

250. 250

     Shahin Gharakhanian, Franck Boccara, Jacqueline Capeau. (2006) Statins in HIV-associated lipodystrophy and metabolic syndrome: is there a missing link?. AIDS 20:7, 1061-1063
     CrossRef

251. 251

     C. Goujard, M. Bonarek, L. Meyer, F. Bonnet, M.-L. Chaix, C. Deveau, M. Sinet, J. Galimand, J.-F. Delfraissy, A. Venet, C. Rouzioux, P. Morlat, . (2006) CD4 Cell Count and HIV DNA Level Are Independent Predictors of Disease Progression after Primary HIV Type 1 Infection in Untreated Patients. Clinical Infectious Diseases 42:5, 709-715
     CrossRef

252. 252

     Stacy D. Fisher, Tracie L. Miller, Steven E. Lipshultz. (2006) Impact of HIV and highly active antiretroviral therapy on leukocyte adhesion molecules, arterial inflammation, dyslipidemia, and atherosclerosis. Atherosclerosis 185:1, 1-11
     CrossRef

253. 253

     Maud Lemoine, Véronique Barbu, Pierre Marie Girard, Minji Kim, Jean-Philippe Bastard, Dominique Wendum, François Paye, Chantal Housset, Jacqueline Capeau, Lawrence Serfaty. (2006) Altered hepatic expression of SREBP-1 and PPARγ is associated with liver injury in insulin-resistant lipodystrophic HIV-infected patients. AIDS 20:3, 387-395
     CrossRef

254. 254

     M. P. Dube. (2006) HIV-Associated Lipoatrophy: What Are the Kinder, Gentler Agents?. Clinical Infectious Diseases 42:2, 281-282
     CrossRef

255. 255

     V. M. Carter, I. Woolley, D. Jolley, I. Nyulasi, A. Mijch, A. Dart. (2006) A randomised controlled trial of omega-3 fatty acid supplementation for the treatment of hypertriglyceridemia in HIV-infected males on highly active antiretroviral therapy. Sexual Health 3:4, 287
     CrossRef

256. 256

     DALMO CORREIA, LUIZ ANTONIO PERTILLI RODRIGUES DE RESENDE, RODRIGO JULIANO MOLINA, BRUNO DORIGUETTO COUTO FERREIRA, FERNANDO COLOMBARI, CARLOS JOSE DORNAS G. BARBOSA, VALDO JOSE DIAS DA SILVA, ALUIZIO PRATA. (2006) Power Spectral Analysis of Heart Rate Variability in HIV-Infected and AIDS Patients. Pacing and Clinical Electrophysiology 29:1, 53-58
     CrossRef

257. 257

     Patrick W. G. Mallon. (2006) Antiretroviral Therapy and Dyslipidaemia: Unlocking the Code. PLoS Medicine 3:3, e85
     CrossRef

258. 258

     Andrea S. Foulkes, David A. Wohl, Ian Frank, Elaine Puleo, Stephanie Restine, Megan L. Wolfe, Michael P. Dube, Pablo Tebas, Muredach P. Reilly. (2006) Associations among Race/Ethnicity, ApoC-III Genotypes, and Lipids in HIV-1-Infected Individuals on Antiretroviral Therapy. PLoS Medicine 3:3, e52
     CrossRef

259. 259

     Katrin Utech, Kaspar Berneis. 2005. Cachexia Associated with AIDS. , 143-164.
     CrossRef

260. 260

     Dirk Schürmann, Jürgen Rademaker, Thomas Trottenberg, Frank Bergmann, Hans Wesselmann, Norbert Suttorp. (2005) Spinal epidural lipomatosis: a manifestation of HAART-associated lipodystrophy. AIDS 19:17, 2052-2054
     CrossRef

261. 261

     Dorothea Wunder, Nick A Bersinger, Christoph Fux, Rainer Weber, Enos Bernasconi, Matthias Cavassini, Heiner C Bucher, Veronique Schiffer, Patrick Schmid, Hansjakob Furrer. (2005) Plasma leptin levels in men are not related to the development of lipoatrophy during antiretroviral therapy. AIDS 19:16, 1837-1842
     CrossRef

262. 262

     Antonella Monforte, Marco Bongiovanni. (2005) Cerebrovascular disease in highly active antiretroviral therapy–treated individuals: Incidence and risk factors. Journal of NeuroVirology 11:0, 34-37
     CrossRef

263. 263

     Judith A. Aberg, Robert A. Zackin, Susan W. Brobst, Scott R. Evans, Beverly L. Alston, W. Keith Henry, Marshall J. Glesby, Francesca J. Torriani, Yijun Yang, Susan I. Owens, Carl J. Fichtenbaum. (2005) A Randomized Trial of the Efficacy and Safety of Fenofibrate versus Pravastatin in HIV-Infected Subjects with Lipid Abnormalities: AIDS Clinical Trials Group Study 5087. AIDS Research and Human Retroviruses 21:9, 757-767
     CrossRef

264. 264

     Andrea R. Nawrocki, Philipp E. Scherer. (2005) Keynote review: The adipocyte as a drug discovery target. Drug Discovery Today 10:18, 1219-1230
     CrossRef

265. 265

     Jutta K Neuenburg, Scott Furlan, Peter Bacchetti, Richard W Price, Robert M Grant. (2005) Enrichment of activated monocytes in cerebrospinal fluid during antiretroviral therapy. AIDS 19:13, 1351-1359
     CrossRef

266. 266

     Vicente F Corrales-Medina, Freddy del Carpio, Ronald Concha, Stephen Symes. (2005) Statins and HIV: Beyond the Metabolic and Cardiovascular Benefit. JAIDS Journal of Acquired Immune Deficiency Syndromes 39:4, 503-504
     CrossRef

267. 267

     Michelle S. Cespedes, Judith A. Aberg. (2005) Cardiovascular and endothelial disease in HIV infection. Current Infectious Disease Reports 7:4, 309-315
     CrossRef

268. 268

     Evan Wood, Robert S Hogg, P Richard Harrigan, Julio SG Montaner. (2005) When to initiate antiretroviral therapy in HIV-1-infected adults: a review for clinicians and patients. The Lancet Infectious Diseases 5:7, 407-414
     CrossRef

269. 269

     Cesar Fisac, Emilio Fumero, Manuel Crespo, Beatriz Roson, Elena Ferrer, Nuria Virgili, Esteban Ribera, Jose Maria Gatell, Daniel Podzamczer. (2005) Metabolic benefits 24 months after replacing a protease inhibitor with abacavir, efavirenz or nevirapine. AIDS 19:9, 917-925
     CrossRef

270. 270

     David Alain Wohl. (2005) Body shape, lipid, and cardiovascular complications of HIV therapy. Current HIV/AIDS Reports 2:2, 74-82
     CrossRef

271. 271

     (2005) Cardiovascular Risk and Body-Fat Abnormalities in HIV-Infected Adults. New England Journal of Medicine 352:16, 1721-1722
     Full Text

272. 272

     Florin M. Malita, Antony D. Karelis, Emil Toma, Remi Rabasa-Lhoret. (2005) Effects of Different Types of Exercise on Body Composition and Fat Distribution in HIV-Infected Patients: A Brief Review. Canadian Journal of Applied Physiology 30:2, 233-245
     CrossRef

Letters