Drug therapies for HIV-related metabolic disorders
| Autor: | Francesc Vidal, Ana García Sarasola, Pere Domingo, Karuna Lamarca |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Drug Cart Simvastatin medicine.medical_specialty media_common.quotation_subject Population Psychological intervention HIV Infections Disease Pharmacology 03 medical and health sciences 0302 clinical medicine Insulin resistance Ezetimibe Intervention (counseling) medicine Humans Pharmacology (medical) 030212 general & internal medicine Rosuvastatin Calcium education Intensive care medicine Dyslipidemias media_common education.field_of_study business.industry General Medicine medicine.disease 030112 virology Cardiovascular Diseases Hydroxymethylglutaryl-CoA Reductase Inhibitors business medicine.drug |
| Zdroj: | Expert Opinion on Pharmacotherapy. 17:1327-1338 |
| ISSN: | 1744-7666 1465-6566 |
| DOI: | 10.1080/14656566.2016.1187133 |
| Popis: | Human immunodeficiency virus (HIV) has become a chronic disease often associated with dyslipidaemia and insulin resistance. Combination antiretroviral therapy (cART) may contribute to metabolic disturbances, eventually leading to increased cardiovascular disease (CVR) in this population. Escalating interventions to decrease CVR include promoting a healthy lifestyle, such as quitting smoking, diet and regular exercise. If they do not achieve the goals, a change of cART should be considered, followed by or used concomitantly with the use of chemical therapies.The aim of this article is to review the available drug therapies for the treatment of metabolic disorders in HIV-infected patients and to examine their safety and effectiveness in this population. A review of the literature was conducted, highlighting the most relevant articles.Switching strategies can be useful but its expected benefit is not high. Therefore, chemical intervention is often needed. Statins have been proven to reduce CVR in the general population and in HIV-infected patients. Simvastatin is contraindicated in patients treated with boosted PI due to interactions; atorvastatin is safe at submaximal dose and needs close monitoring, while pravastatin lacks lipid-lowering potency, and rosuvastatin and pitavastatin are safe. Ezetimibe and fibrates are also safe and effective in HIV-infected patients and can be used in combination with statins. The management of glucose homeostatic disorders in HIV-infected patients follows the same guidelines as in the general population. However, there are specific considerations with respect to the interactions of particular medications with cART. When drug therapy is needed, metformin is the first-line drug. Decisions regarding second- and third-line drugs should be carefully individualized. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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