Treatment of dyslipidaemia in HIV-infected persons.

Détails

ID Serval
serval:BIB_504A35989DEB
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Treatment of dyslipidaemia in HIV-infected persons.
Périodique
Expert Opinion on Pharmacotherapy
Auteur(s)
Manuel O., Thiébaut R., Darioli R., Tarr P.E.
ISSN
1744-7666
Statut éditorial
Publié
Date de publication
2005
Peer-reviewed
Oui
Volume
6
Numéro
10
Pages
1619-1645
Langue
anglais
Notes
Journal Article Review --- Old month value: Aug
Résumé
Accumulating evidence suggests that HIV-infected individuals have an increased risk of cardiovascular events. This risk seems to be at least partially mediated by dyslipidaemia, which is related to the use of highly active antiretroviral therapy (HAART). As HIV-infected individuals live longer due to HAART, their cardiovascular risk will invariably increase. Because HAART is likely to be used indefinitely, HAART-related dyslipidaemia has emerged as a major cardiovascular concern. This article summarises the evaluation of dyslipidaemia and cardiovascular risk in HIV-infected individuals, the potential pathophysiological and genetic mechanisms involved in HAART-related dyslipidaemia and the current treatment approaches. In general, dyslipidaemia is evaluated and treated as in HIV-negative persons. The first step is cardiovascular risk assessment and the determination of target lipid levels. A healthier lifestyle and, in particular, smoking cessation should be promoted. Lowering levels of low-density lipoprotein cholesterol (or, in the setting of significant hypertriglyceridaemia, non-high-density lipoprotein cholesterol) is the primary target of intervention. Switching HAART to a more lipid-favourable regimen should be considered if this does not jeopardise virological control. Many patients will need lipid-lowering drug therapy. Appropriate low-density lipoprotein cholesterol target levels may be more difficult to reach than in the HIV-negative population, and the potential for drug interactions when using lipid-lowering agents together with HAART needs to be considered. The identification of HAART strategies with no or minimal metabolic toxicity, and the identification of the safest and most efficacious lipid-lowering therapies for HIV-infected individuals with dyslipidaemia are important research goals.
Mots-clé
Antilipemic Agents, Antiretroviral Therapy, Highly Active, Clinical Trials as Topic, Dyslipidemias, Exercise, HIV Infections, HIV-1, Humans, Smoking Cessation
Pubmed
Web of science
Création de la notice
28/01/2008 12:45
Dernière modification de la notice
03/03/2018 17:08
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