Recent data on adipose tissue, insulin resistance, diabetes and dyslipidaemia in antiretroviral therapy controlled HIV-infected persons

Purpose of review Increased total body fat with truncal redistribution is common in antiretroviral therapy (ART)-controlled persons living HIV(PLWH), leading to insulin resistance, prediabetes/diabetes and dyslipidaemia. We address these topics here. Recent findings Most antiretrovirals are associated gain trunk fat, including visceral adipose tissue (VAT). Protease-inhibitors could inhibit white ability dissipate energy (i.e. beiging) favouring gain. Expansion VAT a pro-inflammatory profile linked the tryptophan-kynurenine pathway CD4+ subtypes. ART-associated increased (AT) quantity leads decreased AT density, resistance dyslipidaemia that be improved by lifestyle modifications. PLWH present high level regardless their treatment, higher prevalence prediabetes, but not diabetes, than noninfected persons. Otherwise, HbA1c values appear inaccurate diagnose PLWH. ART-related-dyslipidaemia characterized elevated LDL-C and/or triglycerides reduced HDL-C. Whereas treatment protease inhibitors generally results worsened lipid values, integrase-strand-transfer-inhibitors better profile. Tenofovir-alafenamide levels tenofovir-disoproxil-fumarate. Treatment LDL-C-dyslipidaemia benefit, statin-insufficiently controlled patients, from class proprotein-convertase-subtilsin-kenin-type-9 (PCSK-9) inhibitors. Summary Lifestyle modifications mandatory reduce improve dysglycaemia/dyslipidaemia. New drugs can efficiently control diabetes LDL-C-dyslipidaemia.