Marcus V L Dos-Santos-Quaresma, Sandra M Lima-Ribeiro
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Sarcopenia in Persons Living with HIV under Antiretroviral Therapy: Literature Review.
The epidemiological profile of people living with HIV (PLWH) has expressively changed since the introduction of antiretroviral therapy (ART), from a high mortality rate to a profile similar to those living with chronic diseases. Despite the advances and effectiveness of ART, there are still various challenges to overcome, and we highlight the increased risk of sarcopenia in PLWH. This review study aims to (i) explore the pathophysiological background of sarcopenia in PLWH under the different existing ART and (ii) develop a mini-systematic review searching epidemiological studies investigating sarcopenia prevalence in PLWH. As our main findings: we established the risk of sarcopenia development, under a sequential path involving HIV, ART, immune activation, low-grade systemic inflammation, metabolic disorders, and changes in protein synthesis and breakdown in skeletal muscle tissue; some ART drugs, mainly reverse transcriptase inhibitors and protease inhibitors, contribute to critical metabolic changes, lowering the autophagy, increasing mitochondrial dysfunction and insulin resistance, which favor the development of inflammation and muscle protein breakdown. There is still insufficient data to discuss the effects of the new generation drugs, namely integrase inhibitors and fusion inhibitors, on skeletal muscle. More studies are needed to better clarify these relationships.
期刊介绍:
AIDS Reviews publishes papers reporting original scientific, clinical, epidemiologic and social research which contribute to the overall knowledge of the field of the acquired immunodeficiency syndrome and human retrovirology. Currently, the Journal publishes review articles (usually by invitation, but spontaneous submitted articles will also be considered). Manuscripts submitted to AIDS Reviews will be accepted on the understanding that the authors have not submitted the paper to another journal or published the material elsewhere.