Skip to main content
    • Aa
    • Aa

Nutrition and the HIV-associated lipodystrophy syndrome

  • Cathríona Rosemary Loonam (a1) and Anne Mullen (a1)

HIV-associated lipodystrophy syndrome (HALS), comprising metabolic and morphological alterations, is a known side effect of highly active antiretroviral therapy (HAART). Evidence for the role of nutrition in the management of the systemic parameters of HALS is currently limited. In the present paper we review the current knowledge base surrounding HALS, focusing particularly on the role of nutrition in mitigating the systemic parameters of the syndrome. Reported prevalence of HALS was found to vary from 9 to 83 % due to lack of a standardised definition, as well as variations in assessment methods and in the study population used. HALS is associated with both morphological (lipoatrophy, lipohypertrophy) and metabolic (dyslipidaemia, glucose intolerance, diabetes, hypertension, endothelial dysfunction and atherosclerosis) alterations, which may occur singly or in combination, and are associated with an increased risk of CVD. HAART-induced adipocyte inflammation, oxidative stress and macrophage infiltration, as well as altered adipocyte function and mitochondrial toxicity, have been shown to be central to the development of HALS. The adipocyte, therefore, represents a plausible target for treatment. Pharmacological and surgical treatment interventions have shown effect. However, their use is associated with numerous adverse effects and complications. Targeted lifestyle interventions may provide a useful alternative for managing HALS owing to their safety and tolerability. A Mediterranean-style diet has been found to be effective in improving the systemic parameters of HALS. Furthermore, the effects of n-3 PUFA supplementation are encouraging and future randomised controlled trials investigating the beneficial effects of n-3 PUFA in HALS are justified.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Nutrition and the HIV-associated lipodystrophy syndrome
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Nutrition and the HIV-associated lipodystrophy syndrome
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Nutrition and the HIV-associated lipodystrophy syndrome
      Available formats
Corresponding author
*Corresponding author: Dr Anne Mullen, fax +44 20 7848 4171, email
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1S Reynolds & T Quinn (2010) Setting the stage: current state of affairs and major challenges. Clin Infect Dis 50, Suppl. 3, S71S76.

5MP de Béthune (2010) Non-nucleoside reverse transcriptase inhibitors (NNRTIs), their discovery, development, and use in the treatment of HIV-1 infection: a review of the last 20 years (1989–2009). Antiviral Res 85, 7590.

8E De Clercq (1998) The role of non-nucleoside reverse transcriptase inhibitors (NNRTIs) in the therapy of HIV-1 infection. Antiviral Res 38, 153179.

9TN Kakuda (2000) Pharmacology of nucleoside and nucleotide reverse transcriptase inhibitor-induced mitochondrial toxicity. Clin Ther 22, 685708.

11GH Wynn , MJ Zapor , BH Smith , et al. (2004) Antiretrovirals, part 1: overview, history, and focus on protease inhibitors. Psychosomatics 45, 262270.

12ML Greenberg & N Cammack (2004) Resistance to enfuvirtide, the first HIV fusion inhibitor. J Antimicrob Chemother 54, 333340.

15MP Dubé , DL Johnson , JS Currier , et al. (1997) Protease inhibitor-associated hyperglycaemia. Lancet 350, 713714.

17RL Hengel , NB Watts & JL Lennox (1997) Benign symmetric lipomatosis associated with protease inhibitors. Lancet 350, 1596.

19R Viraben & C Aquilina (1998) Indinavir-associated lipodystrophy. AIDS 12, F37F39.

24SW Worm , N Friis-Møller , M Bruyand , et al. (2010) High prevalence of the metabolic syndrome in HIV-infected patients: impact of different definitions of the metabolic syndrome. AIDS 24, 427435.

25K Samaras , H Wand , M Law , et al. (2007) Prevalence of metabolic syndrome in HIV-infected patients receiving highly active antiretroviral therapy using International Diabetes Foundation and Adult Treatment Panel III criteria. Diabetes Care 30, 113119.

28TT Brown , SR Cole , X Li , et al. (2005) Antiretroviral therapy and the prevalence and incidence of diabetes mellitus in the Multicenter AIDS Cohort Study. Arch Intern Med 165, 11791184.

32K Mondy , E Overton , J Grubb , et al. (2007) Metabolic syndrome in HIV-infected patients from an urban, midwestern US outpatient population. Clin Infect Dis 44, 726734.

34S Matetzky , M Domingo , S Kar , et al. (2003) Acute myocardial infarction in human immunodeficiency virus-infected patients. Arch Intern Med 163, 457460.

37N Friis-Møller , R Thiébaut , P Reiss , et al. (2010) Predicting the risk of cardiovascular disease in HIV-infected patients: the data collection on adverse effects of anti-HIV drugs study. Eur J Cardiovasc Prev Rehabil 17, 491501.

38G Guaraldi , S Zona , N Alexopoulos , et al. (2009) Coronary aging in HIV-infected patients. Clin Infect Dis 49, 17561762.

44S Tsiodras , K-A Poulia , M Yannakoulia , et al. (2009) Adherence to Mediterranean diet is favorably associated with metabolic parameters in HIV-positive patients with the highly active antiretroviral therapy-induced metabolic syndrome and lipodystrophy. Metabolism 58, 854859.

46DL Jacobson , AM Tang , D Spiegelman , et al. (2006) Incidence of metabolic syndrome in a cohort of HIV-infected adults and prevalence relative to the US population (National Health and Nutrition Examination Survey). J Acquir Immune Defic Syndr 43, 458466.

47ME Sobieszczyk , DR Hoover , K Anastos , et al. (2008) Prevalence and predictors of metabolic syndrome among HIV-infected and HIV-uninfected women in the Women's Interagency HIV Study. J Acquir Immune Defic Syndr 48, 272280.

48PC Tien , SR Cole , CM Williams , et al. (2003) Incidence of lipoatrophy and lipohypertrophy in the Women's Interagency HIV Study. J Acquir Immune Defic Syndr 34, 461466.

49A Norris & HM Dreher (2004) Lipodystrophy syndrome: the morphologic and metabolic effects of antiretroviral therapy in HIV infection. J Assoc Nurses AIDS Care 15, 4664.

50P Benn , C Ruff , J Cartledge , et al. (2003) Overcoming subjectivity in assessing facial lipoatrophy: is there a role for three-dimensional laser scans? HIV Med 4, 325331.

52FDA Boufassa , AS Lascaux , L Meyer , et al. (2001) Lipodystrophy in 685 HIV-1-treated patients: influence of antiretroviral treatment and immunovirological response. HIV Clin Trials 2, 339345.

54M Galli , A Cozzi-Lepri , AL Ridolfo , et al. (2002) Incidence of adipose tissue alterations in first-line antiretroviral therapy: The LipoICoNa Study. Arch Intern Med 162, 26212628.

55M Galli , F Veglia , G Angarano , et al. (2003) Gender differences in antiretroviral drug-related adipose tissue alterations: women are at higher risk than men and develop particular lipodystrophy patterns. J Acquir Immune Defic Syndr 34, 5861.

59EM Mutimura , AP Stewart , PMD Rheeder , et al. (2007) Metabolic function and the prevalence of lipodystrophy in a population of HIV-infected African subjects receiving highly active antiretroviral therapy. J Acquir Immune Defic Syndr 46, 451455.

60A Nguyen , A Calmy , V Schiffer , et al. (2008) Lipodystrophy and weight changes: data from the Swiss HIV Cohort Study, 2000–2006. HIV Med 9, 142150.

63T Saint-Marc , M Partisani , I Poizot-Martin , et al. (2000) Fat distribution evaluated by computed tomography and metabolic abnormalities in patients undergoing antiretroviral therapy: preliminary results of the LIPOCO study. AIDS 14, 3749.

64R Thiébaut , V Daucourt , P Mercié , et al. (2000) Lipodystrophy, metabolic disorders, and human immunodeficiency virus infection: Aquitaine Cohort, France, 1999. Clin Infect Dis 31, 14821487.

65KA Lichtenstein , DJ Ward , AC Moorman , et al. (2001) Clinical assessment of HIV-associated lipodystrophy in an ambulatory population. AIDS 15, 13891398.

66KV Heath , J Singer , MV O'Shaughnessy , et al. (2002) Intentional nonadherence due to adverse symptoms associated with antiretroviral therapy. J Acquir Immune Defic Syndr 31, 211217.

69KA Lichtenstein , KM Delaney , C Armon , et al. (2003) Incidence of and risk factors for lipoatrophy (abnormal fat loss) in ambulatory HIV-1-infected patients. J Acquir Immune Defic Syndr 32, 4856.

71J van Griensven , L De Naeyer , T Mushi , et al. (2007) High prevalence of lipoatrophy among patients on stavudine-containing first-line antiretroviral therapy regimens in Rwanda. Trans R Soc Trop Med Hyg 101, 793798.

72S Walmsley , A Cheung , G Fantus , et al. (2008) A prospective study of body fat redistribution, lipid, and glucose parameters in HIV-infected patients initiating combination antiretroviral therapy. HIV Clin Trials 9, 314323.

73D Jevtovic , G Dragovic , D Salemovic , et al. (2009) The metabolic syndrome, an epidemic among HIV-infected patients on HAART. Biomed Pharmacother 63, 337342.

74S Mercier , NFN Gueye , A Cournil , et al. (2009) Lipodystrophy and metabolic disorders in HIV-1-infected adults on 4- to 9-year antiretroviral therapy in Senegal: a case–control study. J Acquir Immune Defic Syndr 51, 224230.

76C Gervasoni , AL Ridolfo , G Trifiro , et al. (1999) Redistribution of body fat in HIV-infected women undergoing combined antiretroviral therapy. AIDS 13, 465471.

78KV Heath , RS Hogg , KJ Chan , et al. (2001) Lipodystrophy-associated morphological, cholesterol and triglyceride abnormalities in a population-based HIV/AIDS treatment database. AIDS 15, 231239.

81M Savès , F Raffi , J Capeau , et al. (2002) Factors related to lipodystrophy and metabolic alterations in patients with human immunodeficiency virus infection receiving highly active antiretroviral therapy. Clin Infect Dis 34, 13961405.

82A Carr , S Emery , M Law , et al. (2003) An objective case definition of lipodystrophy in HIV-infected adults: a case–control study. Lancet 361, 726735.

84J Fellay , B Ledergerber , E Bernasconi , et al. (2001) Prevalence of adverse events associated with potent antiretroviral treatment: Swiss HIV Cohort Study. Lancet 358, 13221327.

87C Jericó , H Knobel , M Montero , et al. (2005) Metabolic syndrome among HIV-infected patients: prevalence, characteristics, and related factors. Diabetes Care 28, 132137.

88A Elgalib , M Aboud , R Kulasegaram , et al. (2011) The assessment of metabolic syndrome in UK patients with HIV using two different definitions: CREATE 2 study. Curr Med Res Opin 27, 6369.

90E Gkrania-Klotsas & A-E Klotsas (2007) HIV and HIV treatment: effects on fats, glucose and lipids. Br Med Bull 84, 4968.

93SH Han , J Zhou , S Saghayam , et al. (2011) Prevalence of and risk factors for lipodystrophy among HIV-infected patients receiving combined antiretroviral treatment in the Asia-Pacific region: results from the TREAT Asia HIV Observational Database (TAHOD). Endocr J 58, 475484.

94C Wanke , B Polsky & D Kotler (2002) Guidelines for using body composition measurement in patients with human immunodeficiency virus infection. AIDS Patient Care STDS 16, 375388.

95A Carr , M Law & HIV Lipodystrophy Case Definition Study Group (2003) An objective lipodystrophy severity grading scale derived from the lipodystrophy case definition score. J Acquir Immune Defic Syndr 33, 571576.

96J Fontdevila , JM Serra-Renom , M Raigosa , et al. (2008) Assessing the long-term viability of facial fat grafts: an objective measure using computed tomography. Aesthet Surg J 28, 380386.

98A Carr , K Samaras , A Thorisdottir , et al. (1999) Diagnosis, prediction, and natural course of HIV-1 protease-inhibitor-associated lipodystrophy, hyperlipidaemia, and diabetes mellitus: a cohort study. Lancet 353, 20932099.

99S Safrin & C Grunfeld (1999) Fat distribution and metabolic changes in patients with HIV infection. AIDS 13, 24932505.

105S Grinspoon & A Carr (2005) Cardiovascular risk and body-fat abnormalities in HIV-infected adults. N Engl J Med 352, 4862.

106DL Jacobson , T Knox , D Spiegelman , et al. (2005) Prevalence of, evolution of, and risk factors for fat atrophy and fat deposition in a cohort of HIV-infected men and women. Clin Infect Dis 40, 18371845.

107KD Miller , E Jones , JA Yanovski , et al. (1998) Visceral abdominal-fat accumulation associated with use of indinavir. Lancet 351, 871875.

108WL Dinges , D Chen , PG Snell , et al. (2005) Regional body fat distribution in HIV-infected patients with lipodystrophy. J Investig Med 53, 1525.

109JC Lo , K Mulligan , VW Tai , et al. (1998) “Buffalo hump” in men with HIV-1 infection. Lancet 351, 867870.

111G Guaraldi , G Orlando , N Squillace , et al. (2007) Prevalence of and risk factors for pubic lipoma development in HIV-infected persons. J Acquir Immune Defic Syndr 45, 7276.

114C Grunfeld , DP Kotler , JK Shigenaga , et al. (1991) Circulating interferon-α levels and hypertriglyceridemia in the acquired immunodeficiency syndrome. Am J Med 90, 154162.

116J Tomažič , A Silič , P Karner , et al. (2004) Lipodystrophy and metabolic abnormalities in Slovenian HIV-infected patients. Wien Klin Wochenschr 116, 755759.

117OA Lesi , KS Soyebi & CN Eboh (2009) Fatty liver and hyperlipidemia in a cohort of HIV-positive Africans on highly active antiretroviral therapy. J Natl Med Assoc 101, 151155.

118N Friis-Møller , R Weber , P Reiss , et al. (2003) Cardiovascular disease risk factors in HIV patients – association with antiretroviral therapy. Results from the DAD study. AIDS 17, 11791193.

120D Periard , A Telenti , P Sudre , et al. (1999) Atherogenic dyslipidemia in HIV-infected individuals treated with protease inhibitors. Circulation 100, 700705.

121F van Leth , P Phanuphak , E Stroes , et al. (2004) Nevirapine and efavirenz elicit different changes in lipid profiles in antiretroviral-therapy-naive patients infected with HIV-1. PLoS Med 1, e19.

122R Jones , S Sawleshwarkar , C Michailidis , et al. (2005) Impact of antiretroviral choice on hypercholesterolaemia events: the role of the nucleoside reverse transcriptase inhibitor backbone. HIV Med 6, 396402.

125BZ Monnerat , C Cerutti Junior , SC Caniçali , et al. (2008) Clinical and biochemical evaluation of HIV-related lipodystrophy in an ambulatory population from the Hospital Universitário Cassiano Antonio de Morais, Vitória, ES, Brazil. Braz J Infect Dis 12, 364368.

126H Pernerstorfer-Schoen , B Jilma , A Perschler , et al. (2001) Sex differences in HAART-associated dyslipidaemia. AIDS 15, 725734.

128AS Foulkes , DA Wohl , I Frank , et al. (2006) Associations among race/ethnicity, ApoC-III genotypes, and lipids in HIV-1-infected individuals on antiretroviral therapy. PLoS Med 3, e52.

129M Guardiola , R Ferré , J Salazar , et al. (2006) Protease inhibitor-associated dyslipidemia in HIV-infected patients is strongly influenced by the APOA5-1131T → C gene variation. Clin Chem 52, 19141919.

132D Nolan , C Moore , A Castley , et al. (2003) Tumour necrosis factor-α gene -238G/A promoter polymorphism associated with a more rapid onset of lipodystrophy. AIDS 17, 121123.

133E Tarr Philip , P Taffé , G Bleiber , et al. (2005) Modeling the influence of APOC3, APOE, and TNF polymorphisms on the risk of antiretroviral therapy-associated lipid disorders. J Infect Dis 191, 14191426.

134NN Abourizk , RW Lyons & GM Madden (1993) Transient state of NIDDM in a patient with AIDS. Diabetes Care 16, 931933.

135RA Bradbury & K Samaras (2008) Antiretroviral therapy and the human immunodeficiency virus – improved survival but at what cost? Diabetes Obes Metab 10, 441450.

136JA Eastone & CA Decker (1997) New-onset diabetes mellitus associated with use of protease inhibitor. Ann Intern Med 127, 948.

137F Visnergarwala , KL Krause & DM Musher (1997) Severe diabetes associated with protease inhibitors. Ann Intern Med 127, 947.

138S van Dieren , JWJ Beulens , YT van der Schouw , et al. (2010) The global burden of diabetes and its complications: an emerging pandemic. Eur J Cardiovasc Prev Rehabil 17, Suppl. 1, s3s8.

139G Danaei , MM Finucane , Y Lu , et al. (2011) National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2·7 million participants. Lancet 378, 3140.

140A Carr , J Hudson , J Chuah , et al. (2001) HIV protease inhibitor substitution in patients with lipodystrophy: a randomized, controlled, open-label, multicentre study. AIDS 15, 18111822.

141MP Dubé , RA Parker , P Tebas , et al. (2005) Glucose metabolism, lipid, and body fat changes in antiretroviral-naive subjects randomized to nelfinavir or efavirenz plus dual nucleosides. AIDS 19, 18071818.

143GA Lee , T Seneviratne , MA Noor , et al. (2004) The metabolic effects of lopinavir/ritonavir in HIV-negative men. AIDS 18, 641649.

144H Woerle , PR Mariuz , C Meyer , et al. (2003) Mechanisms for the deterioration in glucose tolerance associated with HIV protease inhibitor regimens. Diabetes 52, 918925.

145PC Tien , MF Schneider , SR Cole , et al. (2007) Antiretroviral therapy exposure and incidence of diabetes mellitus in the Women's Interagency HIV Study. AIDS 21, 17391745.

147DA Wohl , G McComsey , P Tebas , et al. (2006) Current concepts in the diagnosis and management of metabolic complications of HIV infection and its therapy. Clin Infect Dis 43, 645653.

149ER de Arruda Junior , HR Lacerda , LCRV Moura , et al. (2010) Risk factors related to hypertension among patients in a cohort living with HIV/AIDS. Braz J Infect Dis 14, 281287.

150FR Sattler , D Qian , S Louie , et al. (2001) Elevated blood pressure in subjects with lipodystrophy. AIDS 15, 20012010.

152SS Franklin (2008) Beyond blood pressure: arterial stiffness as a new biomarker of cardiovascular disease. J Am Soc Hypertens 2, 140151.

153MGA van Vonderen , YM Smulders , CDA Stehouwer , et al. (2009) Carotid intima-media thickness and arterial stiffness in HIV-infected patients: the role of HIV, antiretroviral therapy, and lipodystrophy. J Acquir Immune Defic Syndr 50, 153161.

155EC Seaberg , L Benning , AR Sharrett , et al. (2010) Association between human immunodeficiency virus infection and stiffness of the common carotid artery. Stroke 41, 21632170.

156SS Shankar & MP Dubé (2004) Clinical aspects of endothelial dysfunction associated with human immunodeficiency virus infection and antiretroviral agents. Cardiovasc Toxicol 4, 261269.

157JH Stein , MA Klein , JL Bellehumeur , et al. (2001) Use of human immunodeficiency virus-1 protease inhibitors is associated with atherogenic lipoprotein changes and endothelial dysfunction. Circulation 104, 257262.

159FJ Torriani , L Komarow , RA Parker , et al. (2008) Endothelial function in human immunodeficiency virus-infected antiretroviral-naive subjects before and after starting potent antiretroviral therapy: The ACTG (AIDS Clinical Trials Group) Study 5152s. J Am Coll Cardiol 52, 569576.

160C Lefèvre , M Auclair , F Boccara , et al. (2010) Premature senescence of vascular cells is induced by HIV protease inhibitors. Arterioscler Thromb Vasc Biol 30, 26112620.

161B Coll , S Parra , C Alonso-Villaverde , et al. (2006) HIV-infected patients with lipodystrophy have higher rates of carotid atherosclerosis: the role of monocyte chemoattractant protein-1. Cytokine 34, 5155.

162L Calza , R Manfredi , D Pocaterra , et al. (2008) Risk of premature atherosclerosis and ischemic heart disease associated with HIV infection and antiretroviral therapy. J Infect 57, 1632.

163RC Kaplan , LA Kingsley , SJ Gange , et al. (2008) Low CD4+ T-cell count as a major atherosclerosis risk factor in HIV-infected women and men. AIDS 22, 16151624.

164K Henry , H Melroe , J Huebsch , et al. (1998) Severe premature coronary artery disease with protease inhibitors. Lancet 351, 1328.

166SA Bozzette , CF Ake , HK Tam , et al. (2003) Cardiovascular and cerebrovascular events in patients treated for human immunodeficiency virus infection. N Engl J Med 348, 702710.

168G Barbaro , G Di Lorenzo , A Cirelli , et al. (2003) An open-label, prospective, observational study of the incidence of coronary artery disease in patients with HIV infection receiving highly active antiretrovial therapy. Clin Ther 25, 24052418.

169JE Mallewa , SP Higgins , S Garbett , et al. (2009) Cardiovascular disease risk management in HIV patients, experiences from Greater Manchester. Int J STD AIDS 20, 425426.

170C Alvarez , R Salazar , J Galindez , et al. (2010) Metabolic syndrome in HIV-infected patients receiving antiretroviral therapy in Latin America. Braz J Infect Dis 14, 256263.

171JJ Schafer , WR Short & KE Squires (2010) Association between abacavir exposure and increased risk for cardiovascular disease in patients with human immunodeficiency virus. Pharmacotherapy 30, 10721083.

172A Martin , J Amin , D Cooper , et al. (2010) Abacavir does not affect circulating levels of inflammatory or coagulopathic biomarkers in suppressed HIV: a randomized clinical trial. AIDS 24, 26572663.

177N Friis-Møller & SW Worm (2007) Editorial commentary: can the risk of cardiovascular disease in HIV-infected patients be estimated from conventional risk prediction tools? Clin Infect Dis 45, 10821084.

178M May , JA Sterne , M Shipley , et al. (2007) A coronary heart disease risk model for predicting the effect of potent antiretroviral therapy in HIV-1 infected men. Int J Epidemiol 36, 13091318.

179E Hammond , E McKinnon & D Nolan (2010) Human immunodeficiency virus treatment-induced adipose tissue pathology and lipoatrophy: prevalence and metabolic consequences. Clin Infect Dis 51, 591599.

180JA Johnson , JB Albu , ES Engelson , et al. (2004) Increased systemic and adipose tissue cytokines in patients with HIV-associated lipodystrophy. Am J Physiol Endocrinol Metab 286, E261E271.

184M Sievers , UA Walker , K Sevastianova , et al. (2009) Gene expression and immunohistochemistry in adipose tissue of HIV type 1-infected patients with nucleoside analogue reverse transcriptase inhibitor-associated lipodystrophy. J Infect Dis 200, 252262.

185J-P Bastard , M Maachi , JT van Nhieu , et al. (2002) Adipose tissue IL-6 content correlates with resistance to insulin activation of glucose uptake both in vivo and in vitro. J Clin Endocrinol Metab 87, 20842089.

187J Kovsan , R Ben-Romano , SC Souza , et al. (2007) Regulation of adipocyte lipolysis by degradation of the perilipin protein. J Biol Chem 282, 2170421711.

189A Rudich , R Ben-Romano , S Etzion , et al. (2005) Cellular mechanisms of insulin resistance, lipodystrophy and atherosclerosis induced by HIV protease inhibitors. Acta Physiol Scand 183, 7588.

190HH Zhang , M Halbleib , F Ahmad , et al. (2002) Tumor necrosis factor-α stimulates lipolysis in differentiated human adipocytes through activation of extracellular signal-related kinase and elevation of intracellular cAMP. Diabetes 51, 29292935.

191M Rydén , E Arvidsson , L Blomqvist , et al. (2004) Targets for TNF-α-induced lipolysis in human adipocytes. Biochem Biophys Res Commun 318, 168175.

192D Adler-Wailes , EL Guiney , J Koo , et al. (2008) Effects of ritonavir on adipocyte gene expression: evidence for a stress-related response. Obesity 16, 23792387.

195A Körner , M Wabitsch , B Seidel , et al. (2005) Adiponectin expression in humans is dependent on differentiation of adipocytes and down-regulated by humoral serum components of high molecular weight. Biochem Biophys Res Commun 337, 540550.

196M Pacenti , L Barzon , F Favaretto , et al. (2006) Microarray analysis during adipogenesis identifies new genes altered by antiretroviral drugs. AIDS 20, 16911705.

198K Sevastianova , J Sutinen , K Kannisto , et al. (2008) Adipose tissue inflammation and liver fat in patients with highly active antiretroviral therapy-associated lipodystrophy. Am J Physiol Endocrinol Metab 295, E85E91.

204G Birkus , MJM Hitchcock & T Cihlar (2002) Assessment of mitochondrial toxicity in human cells treated with tenofovir: comparison with other nucleoside reverse transcriptase inhibitors. Antimicrob Agents Chemother 46, 716723.

206UA Walker , B Setzer & N Venhoff (2002) Increased long-term mitochondrial toxicity in combinations of nucleoside analogue reverse-transcriptase inhibitors. AIDS 16, 21652173.

207E Ribera , JC Paradiñeiro , A Curran , et al. (2008) Improvements in subcutaneous fat, lipid profile, and parameters of mitochondrial toxicity in patients with peripheral lipoatrophy when stavudine is switched to tenofovir (LIPOTEST Study). HIV Clin Trials 9, 407417.

210M Sension , JL de Andrade Neto , B Grinsztejn , et al. (2009) Improvement in lipid profiles in antiretroviral-experienced HIV-positive patients with hyperlipidemia after a switch to unboosted atazanavir. J Acquir Immune Defic Syndr 51, 153162.

214C Fichtenbaum , JG Gerber , SL Rosenkranz , et al. (2002) Pharmacokinetic interactions between protease inhibitors and statins in HIV seronegative volunteers: ACTG Study A5047. AIDS 16, 569577.

215T Feldt , M Oette , A Kroidl , et al. (2006) Evaluation of safety and efficacy of rosiglitazone in the treatment of HIV-associated lipodystrophy syndrome. Infection 34, 5561.

216JM Raboud , C Diong , A Carr , et al. (2010) A meta-analysis of six placebo-controlled trials of thiazolidinedione therapy for HIV lipoatrophy. HIV Clin Trials 11, 3950.

218JPH van Wijk , AIM Hoepelman , EJP de Koning , et al. (2011) Differential effects of rosiglitazone and metformin on postprandial lipemia in patients with HIV-lipodystrophy. Arterioscler Thromb Vasc Biol 31, 228233.

219I Jiménez-Nácher , E Alvarez , J Morello , et al. (2011) Approaches for understanding and predicting drug interactions in human immunodeficiency virus-infected patients. Expert Opin Drug Metab Toxicol 7, 457477.

220E Martínez (2011) Disorders of fat partitioning in treated HIV-infection. Best Prac Res Clin Endocrinol Metab 25, 415427.

222BM Psaty & CD Furberg (2007) Rosiglitazone and cardiovascular risk. N Engl J Med 356, 25222524.

223CS Hultman , LE McPhail , JH Donaldson , et al. (2007) Surgical management of HIV-associated lipodystrophy: role of ultrasonic-assisted liposuction and suction-assisted lipectomy in the treatment of lipohypertrophy. Ann Plas Surg 58, 255263.

224A Warren & LJ Borud (2008) Excisional lipectomy for HIV-associated cervicodorsal lipodystrophy. Aesthet Surg J 28, 147152.

226L Skeie , H Bugge , A Negaard , et al. (2010) Large particle hyaluronic acid for the treatment of facial lipoatrophy in HIV-positive patients: 3-year follow-up study. HIV Med 11, 170177.

227C Dollfus , S Blanche , N Trocme , et al. (2009) Correction of facial lipoatrophy using autologous fat transplants in HIV-infected adolescents. HIV Med 10, 263268.

228P Narciso , R Bucciardini , V Tozzi , et al. (2009) Immediate versus delayed surgical intervention for reconstructive therapy of HIV-associated facial lipoatrophy: a randomized open-label study. AIDS Res Hum Retroviruses 25, 979987.

229G Guaraldi , N Squillace , D De Fazio , et al. (2009) Heterologous fat transplantation for the treatment of HIV-related facial lipoatrophy. Ann Intern Med 150, 6163.

230L Terry , E Sprinz , R Stein , et al. (2006) Exercise training in HIV-1-infected individuals with dyslipidemia and lipodystrophy. Med Sci Sports Exerc 38, 411417.

231R Roubenoff , L Weiss , A McDermott , et al. (1999) A pilot study of exercise training to reduce trunk fat in adults with HIV-associated fat redistribution. AIDS 13, 13731375.

233KE Yarasheski & R Roubenoff (2001) Exercise treatment for HIV-associated medical and anthropomorphic complications. Exerc Sport Sci Rev 29, 170174.

234S Fillipas , CL Cherry , F Cicuttini , et al. (2010) The effects of exercise training on metabolic and morphological outcomes for people living with HIV: a systematic review of randomised controlled trials. HIV Clin Trials 11, 270282.

237B Lindegaard , T Hansen , T Hvid , et al. (2008) The effect of strength and endurance training on insulin sensitivity and fat distribution in human immunodeficiency virus-infected patients with lipodystrophy. J Clin Endocrinol Metab 93, 38603869.

238C Hadigan (2003) Dietary habits and their association with metabolic abnormalities in human immunodeficiency virus-related lipodystrophy. Clin Infect Dis 37, Suppl. 2, S101S104.

239A Gavrila , S Tsiodras , J Doweiko , et al. (2003) Exercise and vitamin E intake are independently associated with metabolic abnormalities in human immunodeficiency virus-positive subjects: a cross-sectional study. Clin Infect Dis 36, 15931601.

240MJ Batterham , R Garsia & PA Greenop (2000) Dietary intake, serum lipids, insulin resistance and body composition in the era of highly active antiretroviral therapy ‘Diet FRS Study’. AIDS 14, 18391843.

241K Samaras , H Wand , M Law , et al. (2009) Dietary intake in HIV-infected men with lipodystrophy: relationships with body composition, visceral fat, lipid, glucose and adipokine metabolism. Curr HIV Res 7, 454461.

242A Barrios , F Blanco , T Garcia-Benayas , et al. (2002) Effect of dietary intervention on highly active antiretroviral therapy-related dyslipemia. AIDS 16, 20792081.

244R Roubenoff , H Schmitz , L Bairos , et al. (2002) Reduction of abdominal obesity in lipodystrophy associated with human immunodeficiency virus infection by means of diet and exercise: case report and proof of principle. Clin Infect Dis 34, 390393.

247S Benedini , G Perseghin , I Terruzzi , et al. (2009) Effect of l-acetylcarnitine on body composition in HIV-related lipodystrophy. Horm Metab Res 41, 840845.

252A Balasubramanyam , I Coraza , EO Smith , et al. (2011) Combination of niacin and fenofibrate with lifestyle changes improves dyslipidemia and hypoadiponectinemia in HIV patients on antiretroviral therapy: results of “heart positive,” a randomized, controlled trial. J Clin Endocrinol Metab 96, 22362247.

256E Razzini & GF Baronzio (1993) Omega-3 fatty acids as coadjuvant treatment in AIDS. Med Hypotheses 41, 300305.

258DA Wohl , HC Tien , M Busby , et al. (2005) Randomized study of the safety and efficacy of fish oil (omega-3 fatty acid) supplementation with dietary and exercise counseling for the treatment of antiretroviral therapy-associated hypertriglyceridemia. Clin Infect Dis 41, 14981504.

260R Manfredi , L Calza & F Chiodo (2004) Polyunsaturated ethyl esters of n-3 fatty acids in HIV-infected patients with moderate hypertriglyceridemia: comparison with dietary and lifestyle changes, and fibrate therapy. J Acquir Immune Defic Syndr 36, 878880.

261J Baril , CM Kovacs , S Trottier , et al. (2007) Effectiveness and tolerability of oral administration of low-dose salmon oil to HIV patients with HAART-associated dyslipidemia. HIV Clin Trials 8, 400411.

263MK Hellerstein , K Wu , M McGrath , et al. (1996) Effects of dietary n-3 fatty acid supplementation in men with weight loss associated with the acquired immune deficiency syndrome: relation to indices of cytokine production. J Acquir Immune Defic Syndr Hum Retrovirol 11, 258270.

265N Virgili , M Farriol , JM Castellanos , et al. (1997) Evaluation of immune markers in asymptomatic AIDS patients receiving fish oil supplementation. Clin Nutr 16, 257261.

266L Normén , B Yip , J Montaner , et al. (2007) Use of metabolic drugs and fish oil in HIV-positive patients with metabolic complications and associations with dyslipidaemia and treatment targets. HIV Med 8, 346356.

268SM Weldon , AC Mullen , CE Loscher , et al. (2007) Docosahexaenoic acid induces an anti-inflammatory profile in lipopolysaccharide-stimulated human THP-1 macrophages more effectively than eicosapentaenoic acid. J Nutr Biochem 18, 250258.

270C Pichard , P Sudre , V Karsegard , et al. (1998) A randomized double-blind controlled study of 6 months of oral nutritional supplementation with arginine and Ω-3 fatty acids in HIV-infected patients. Swiss HIV Cohort Study. AIDS 12, 5363.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Nutrition Research Reviews
  • ISSN: 0954-4224
  • EISSN: 1475-2700
  • URL: /core/journals/nutrition-research-reviews
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score