Metabolic Complications Associated with Use of Integrase Strand Transfer Inhibitors (InSTI) for the Treatment of HIV-1 Infection: Focus on Weight Changes, Lipids, Glucose and Bone Metabolism.

IF 3.7 2区 医学 Q2 INFECTIOUS DISEASES Current HIV/AIDS Reports Pub Date : 2024-12-01 Epub Date: 2024-08-29 DOI:10.1007/s11904-024-00708-x
Stefano Savinelli, Ellen Newman, Patrick W G Mallon
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Abstract

Purpose of review: This review aims to summarize recently published peer reviewed papers on the influence of treatment with Integrase Strand Transfer Inhibitors (InSTI) in people with HIV (HIV) on metabolic health, including weight gain, lipid parameters, glucose homeostasis, and bone health.

Recent findings: InSTI have a mild/moderate effect on weight gain in both antiretroviral (ART) naïve and ART experienced PWH, which is more pronounced in certain groups (i.e. women, people of Black African ethnicity, those with lower socioeconomic status, and older people). The effect on weight is also driven by other components of the ART regimen as well as previous exposure to certain ART. InSTI have a relatively safe profile in terms of lipid parameters and bone health, compared to other ART classes, although some studies suggest a greater risk of insulin resistance and diabetes in PWH using InSTI, especially 2nd generation InSTI. While there is some evidence suggesting a negative impact of InSTI on some aspects of metabolic health (weight gain and glucose homeostasis), they remain the preferred treatment option for most PWH, due to their high efficacy and tolerability. However, an individualised approach to ART choice in PWH should be used in order to avoid negative outcomes in populations at higher risks of metabolic complications.

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与使用整合酶链转移抑制剂 (InSTI) 治疗 HIV-1 感染有关的代谢并发症:关注体重变化、血脂、血糖和骨代谢。
综述目的:本综述旨在总结近期发表的同行评议论文,这些论文涉及使用整合酶链转移抑制剂(InSTI)治疗艾滋病病毒感染者(HIV)对代谢健康的影响,包括体重增加、血脂参数、糖稳态和骨骼健康:InSTI 对抗逆转录病毒疗法(ART)新手和有抗逆转录病毒疗法经验的艾滋病病毒感染者的体重增加有轻度/中度影响,这在某些群体(即女性、黑非洲人种、社会经济地位较低者和老年人)中更为明显。对体重的影响还取决于抗逆转录病毒疗法的其他成分以及以前是否接触过某些抗逆转录病毒疗法。与其他抗逆转录病毒疗法相比,非甾体抗炎药在血脂参数和骨骼健康方面具有相对安全的特征,但一些研究表明,使用非甾体抗炎药(尤其是第二代非甾体抗炎药)的 PWH 患胰岛素抵抗和糖尿病的风险更大。虽然有证据表明 InSTI 对代谢健康的某些方面(体重增加和葡萄糖稳态)有负面影响,但由于其疗效高且耐受性好,仍是大多数 PWH 的首选治疗方案。不过,在为 PWH 选择抗逆转录病毒疗法时,应采用个体化方法,以避免对代谢并发症风险较高的人群造成负面影响。
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来源期刊
Current HIV/AIDS Reports
Current HIV/AIDS Reports INFECTIOUS DISEASES-
CiteScore
8.10
自引率
2.20%
发文量
45
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of HIV/AIDS. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antiretroviral therapies, behavioral aspects of management, and metabolic complications and comorbidity. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
期刊最新文献
Syndemic Theory and Its Use in Developing Health Interventions and Programming: A Scoping Review. Metabolic Complications Associated with Use of Integrase Strand Transfer Inhibitors (InSTI) for the Treatment of HIV-1 Infection: Focus on Weight Changes, Lipids, Glucose and Bone Metabolism. A Review of Implementation Strategies to Enhance PrEP Delivery for People Experiencing Housing Insecurity: Advancing a Multifaceted High-Touch, Low-Barrier Approach. Sex Differences in Metabolic Disorders of Aging and Obesity in People with HIV. Feasibility and Impact of Community Pharmacy and Novel Pick-up Points for Antiretroviral Therapy Pre-exposure Prophylaxis Initiation and Continuation in Low and Middle-income Countries.
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