Cardiovascular Disease in Aids by Giuseppe Barbaro, Franck Boccara, Paul Skolnik, Giorgio

By Giuseppe Barbaro, Franck Boccara, Paul Skolnik, Giorgio Barbarini

Experiences released ahead of the advent of hugely energetic antiretroviral treatment (HAART) tracked the prevalence and process HIV an infection when it comes to cardiac affliction in either childrens and adults. those stories convey that subclinical echocardiographic abnormalities independently expect antagonistic results and determine high-risk teams to be special for early intervention and remedy. The advent of HAART has altered cardiovascular manifestations in HIV. at the one hand, HAART has considerably converted the process HIV illness, lengthened survival, and superior the standard of lifetime of HIV-infected sufferers. however, the early info have raised issues that HAART is linked to a rise in either peripheral and coronary arterial ailments, growing an exciting medical surroundings. This ebook makes a speciality of new medical and organic perception on the topic of HIV-associated metabolic and cardiovascular problems within the HAART period.

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Similarly, the amount of intramyocellular fat has been related to insulin resistance in obese and diabetic patients [18]. This set of alterations has been named lipotoxicity [19]. The location of adipose tissue is probably important: visceral fat, which is highly sensitive to catecholamines and resistant to insulin, is prone to release large amounts of FFA in the portal system which will be driven mainly to the liver. Subcutaneous fat, which is more resistant to lipolysis, would release lower levels of FFA, particularly towards peripheral tissues such as muscles.

AIDS 17:121-123 49. Bastard JP, Caron M, Vidal H et al (2002) Association between altered expression of adipogenic factor 39. 31 32 J. Capeau 50. 51. 52. 53. 54. 55. Pathogenesis of HAART-Associated Metabolic Syndrome SREBP1 in lipoatrophic adipose tissue from HIV-1infected patients and abnormal adipocyte differentiation and insulin resistance. Lancet 359:1026-1031 Domingo P, Matias-Guiu X, Pujol RM et al (1999) Subcutaneous adipocyte apoptosis in HIV-1 protease inhibitor-associated lipodystrophy.

NRTIs were found to be linked primarily to peripheral lipoatrophy and PIs to visceral fat accumulation. Their association increases their prevalence and severity [38]. However, individual molecules of these two classes have different effects. Pathogenesis of HAART-Associated Metabolic Syndrome In Vitro Studies To better understand the pathophysiology of fat alterations, studies were performed first in vitro, so as to decipher the precise role of each drug on adipocyte functions. Most of the studies concerned PIs, since lipodystrophies were diagnosed shortly after their introduction.

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