Alterations of Glucose Metabolism in HIV-Infected Patients
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Purpose of Review
The life expectancy of patients living with human immunodeficiency virus (HIV) has dramatically improved with newer antiretroviral therapy (ART), but these agents are associated with significant increase in metabolic and other non-communicable diseases. The potential for alteration in glucose metabolism should be kept in mind to optimize diagnosis and treatment. The purpose of this review is to assess the pathophysiologic mechanisms by which patients living with HIV may have their glucose metabolism altered and mention the available evidence to improve prompt screening, diagnosis, and treatment.
HIV can impair glucose metabolism primarily by inflammation pathways, but most metabolic alteration is related to antiretroviral agents, usually protease inhibitors (PIs). Although glucose management is similar to the general population, newer agents are being investigated to improve glucose metabolism specifically in HIV-infected patients.
HIV-infected patients should be considered at high risk for alterations of glucose metabolism, including insulin resistance, pre-diabetes, and diabetes, especially after initiating ART. Patients should have glucose screening every 6 to 12 months and every 3 months after initiating ART. Treatment remains similar to the general population, but interactions with antiretroviral agents should be kept in mind.
KeywordsGlucose metabolism Diabetes mellitus HIV
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Conflict of Interest
The author declares no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by the author.
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