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Current HIV/AIDS Reports
Published in: Current HIV/AIDS Reports 5/2018

01-10-2018 | Complications of Antiretroviral Therapy (GA McComsey, Section Editor)

Inflammation and Metabolic Complications in HIV

Authors: Kassem Bourgi, Celestine Wanjalla, John R. Koethe

Published in: Current HIV/AIDS Reports | Issue 5/2018

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Abstract

Purpose of Review

We aim to provide an in-depth review of recent literature highlighting the role of inflammation involving the adipose tissue, liver, skeletal muscles, and gastrointestinal tract in the development of metabolic complications among persons living with HIV (PLWH).

Recent Findings

Recent studies in PLWH have demonstrated a significant association between circulating inflammatory markers and development of insulin resistance and metabolic complications. In adipose tissue, pro-inflammatory cytokine expression inhibits adipocyte insulin signaling, which alters lipid and glucose homeostasis. Increased lipolysis and lipogenesis elevate levels of circulating free fatty acids and promote ectopic fat deposition in liver and skeletal muscles. This leads to lipotoxicity characterized by a pro-inflammatory response with worsening insulin resistance. Finally, HIV is associated with gastrointestinal tract inflammation and changes in the gut microbiome resulting in reduced diversity, which is an additional risk factor for diabetes.

Summary

Metabolic complications in PLWH are in part due to chronic, multisite tissue inflammation resulting in dysregulation of glucose and lipid trafficking, utilization, and storage.
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Metadata
Title
Inflammation and Metabolic Complications in HIV
Authors
Kassem Bourgi
Celestine Wanjalla
John R. Koethe
Publication date
01-10-2018
Publisher
Springer US
Published in
Current HIV/AIDS Reports / Issue 5/2018
Print ISSN: 1548-3568
Electronic ISSN: 1548-3576
DOI
https://doi.org/10.1007/s11904-018-0411-2
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