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New Guidelines on Metabolic Complications of HIV and Antiretroviral Treatment

November 22, 2002

On November 1 a panel of 12 leading experts on metabolic complications of HIV and antiretroviral treatment published guidelines for managing these complications, and a review of what is already known.1 The panel looked at glucose intolerance and diabetes, lipid abnormalities such as high triglycerides, body fat distribution changes, lactic acidemia, and bone problems (both osteonecrosis and osteopenia). Guidelines were accepted by consensus of the full panel -- which was funded by the International AIDS Society-USA (not to be confused with the International AIDS Society, a different organization).

In the absence of urgently needed studies to get better treatment information, "the panel recommends routine assessment and monitoring of glucose and lipid levels and assessment and monitoring of lactic acidemia and bone abnormalities if clinical signs or symptoms are detected. With the exception of body fat distribution abnormalities, specific treatments for these complications are also recommended." Changes in antiretroviral therapy are also suggested, to avoid drugs believed to contribute to the patient's problems.

A copy of the guidelines is available online at:


  1. Schambelan M., Benson C., Carr A., and others. Management of metabolic complications associated with antiretroviral therapy for HIV-1 infection: Recommendations of an International AIDS Society-USA panel. JAIDS (Journal of Acquired Immune Deficiency Syndromes). November 2002; volume 31, pages 257-275,

ISSN # 1052-4207

Copyright 2002 by John S. James. Permission granted for noncommercial reproduction, provided that our address and phone number are included if more than short quotations are used.

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