What Are the Long-Term Metabolic Complications Associated with Antiretroviral Therapy?
The major abnormalities that complicate the management of HIV infection include body morphology changes (lipohypertrophy and lipoatrophy), serum lipid abnormalities, dysregulation of glucose metabolism, lactic acidemia, and bone disorders (reduced bone mineral density and avascular necrosis). Concern has been expressed about long-term cardiovascular morbidity in patients who experience increases in atherogenic serum lipids levels, glucose intolerance, and body fat distribution changes, but as of yet, this risk is not well defined. In general, it appears that the benefits of antiretroviral therapy used in accordance with published guidelines outweigh the risk of cardiovascular disease associated with long-term exposure [69, 70]. Guidelines have been developed to assist providers in the identification and management of lipid abnormalities and metabolic complications [12, 16]. Evidence Summary Recommendations Fasting glucose and lipid levels should be monitored prior to and within 4-6 wee
