Cited by 210HIV-related health complications and treatmentsDiabetes, Cardiovascular Risks, and LipoproteinsHIV/AIDS Research and Interventions

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European AIDS Clinical Society (EACS) guidelines on the prevention and management of metabolic diseases in HIV*

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Lundgren, JD, Battegay, M, Behrens, G, De Wit, S, Guaraldi, G, Katlama, C, Martinez, E, Nair, D, Powderly, WG, Reiss, P, Sutinen, J, Vigano, A, the EACS Executive Committee·2008·HIV Medicine

DOI 10.1111/j.1468-1293.2007.00534.x

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Abstract

Background: Metabolic diseases are frequently observed in HIV‐infected persons and, as the risk of contracting these diseases is age‐related, their prevalence will increase in the future as a consequence of the benefits of antiretroviral therapy (ART). Summary of guidelines: All HIV‐infected persons should be screened at regular intervals for a history of metabolic disease, dyslipidaemia, diabetes mellitus, hypertension and alteration of body composition; cardiovascular risk and renal function should also be assessed. Efforts to prevent cardiovascular disease will vary in intensity depending on an individual's absolute risk of ischaemic heart disease and should be comprehensive in nature. Lifestyle interventions should focus on counselling to stop smoking, modify diet and take regular exercise. A healthy diet, exercise and maintaining normal body weight tend to reduce dyslipidaemia; if not effective, a change of ART should be considered, followed by use of lipid‐lowering medication in high‐risk patients. A pre‐emptive switch from thymidine analogues is recommended to reduce the risk of development or progression of lipoatrophy. Intra‐abdominal fat accumulation is best managed by exercise and diet. Prevention and management of type 2 diabetes mellitus and hypertension follow guidelines used in the general population. When using medical interventions to prevent and/or treat metabolic disease(s), impairment of the efficacy of ART should be avoided by considering the possibility of pharmacokinetic interactions and compromised adherence. Specialists in HIV and specialists in metabolic diseases should consult each other, in particular in difficult‐to‐treat cases. Conclusion: Multiple and relatively simple approaches exist to prevent metabolic diseases in HIV‐infected persons; priority should be given to patients at high risk of contracting these diseases.

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Authors: Lundgren, J., Battegay, M., Behrens, G., De Wit, S., Guaraldi, G., Katlama, C., Martinez, E., Nair, D., Powderly, W., Reiss, P., Sutinen, J., Vigano, A., & the EACS Executive Committee
Affiliations: University Hospital of Basel (CH)
Medizinische Hochschule Hannover (DE)
University of Modena and Reggio Emilia (IT)
Pitié-Salpêtrière Hospital (FR)
The Royal Free Hospital (GB)
Amsterdam UMC Location University of Amsterdam (NL)
Helsinki University Hospital (FI)
ORCID: Battegay, M
Behrens, G
Guaraldi, G
Katlama, C
Nair, D
Reiss, P
Venue: HIV Medicine
Publisher: Wiley
Published: 2008-01-31
Volume: 9
Issue: 2
Pages: 72-81
ISSN: 1464-2662 (ISSN-L)
1468-1293
DOI: 10.1111/j.1468-1293.2007.00534.x
OpenAlex: W2032218832
Cited by: 210
References: 18
Citations by year: 2026: 1 · 2025: 1 · 2024: 3 · 2023: 4 · 2022: 4 · 2021: 5 · 2020: 5 · 2019: 9 · 2018: 5 · 2017: 8 · 2016: 14 · 2015: 14 · 2014: 13 · 2013: 22 · 2012: 19
FWCI: 30.19
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: HIV Medicine (publishedVersion)
PubMed (publishedVersion)
Pure Amsterdam UMC (publishedVersion)
Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
INFM-OAR (INFN Catania) (submittedVersion, other-oa)
Topics: Health Sciences › Medicine › Infectious Diseases › HIV-related health complications and treatments
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Keywords: dyslipidemia, type 2 diabetes, hypertension, lipoatrophy, intra-abdominal fat, cardiovascular risk, antiretroviral therapy, lipid-lowering therapy, lifestyle intervention, body composition, renal function, pharmacokinetic interactions, medication adherence, screening
MeSH terms: Cardiovascular Diseases, Drug Interactions, Humans, Life Style, Metabolic Diseases, HIV Infections, Polypharmacy

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