Highly active antiretroviral therapy (ART) with protease inhibitors (PIs) and nucleoside analogue inhibitors of viral reverse transcrip­tase (NRTI) allowed a major reduction in the severity and morbidity of HIV infection; however, these drugs were associated with the occurrence of secondary effects collec­tively termed “ART-related lipodystrophy or metabolic syndrome.”

This syndrome is defined by alterations in body-fat repartition with peripheral fat loss and/or central fat accumulation together with metabolic disor­ders such as hypertriglyceridemia (hyper- TG), hypercholesterolemia, and insulin resistance sometimes with altered glucose tolerance.

This set of abnormalities shows some similarities with those present in the very common metabolic or insulin-resistance syndrome and some of the pathophysiologi­cal mechanisms are probably the same. In addition, the ART-related metabolic syn­drome probably results from alterations directly related to the treatment and also probably to the ongoing infection in the con­text of altered immunity and modified cytokine profile, which most likely enhances its severity and could be responsible for its specific features.

More on the topic Highly active antiretroviral therapy (ART) with protease inhibitors (PIs) and nucleoside analogue inhibitors of viral reverse transcrip­tase (NRTI) allowed a major reduction in the severity and morbidity of HIV infection; however, these drugs were associated with the occurrence of secondary effects collec­tively termed “ART-related lipodystrophy or metabolic syndrome.”: