The Body Covers: The 3rd International Conference on Nutrition and HIV Infection
HAART, Dyslipidemia, and Hyperglycemia
April 22-25, 1999
HAART has been associated with the frequent appearance of dyslipidemia -- elevated total and LDL cholesterol, decreased HDL cholesterol, elevated triglycerides -- as well as hyperglycemia leading to diabetes. Dr. Morris Shambelan from San Francisco summarized the current understanding of lipid metabolism in HIV infection. Prior to the HAART/PI-era the most common lipid abnormalities reported were elevations in serum triglycerides and declines in total cholesterol related to increased de novo lipogenesis and lipolysis. Post-HAART, post-PI triglyceride elevations are more marked and now associated with cholesterol elevation also. There is controversy about the potential clinical significance of these alterations. Case reports of presumably lipid-related coronary artery disease in individuals with HIV infection have been appearing. Fat redistribution syndrome mimics a non-HIV metabolic syndrome (Syndrome X) with a very high incidence of coronary and other vascular complications. The possibility of an aging (due to increased survival) population of men and women with HIV infection developing similar complications is both real and frightening. Dr. Carl Grunfeld previously demonstrated that the risk of these complications in HIV infection might actually be quite modest and much less than the risk from traditional cardiac risk factors such as smoking. Indeed the risk of death from untreated HIV infection and AIDS is much higher.
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