What is known about the biochemical abnormalities in HIV?

What is known about the biochemical abnormalities in HIV?What is known about the biochemical abnormalities in HIV?

Unlike the physical (morphologic) abnormalities described above, fat (lipid) and sugar (glucose) changes (metabolic abnormalities) appear to be more closely linked to certain antiviral agents, particularly protease inhibitors. These conditions are often managed by changing the HIV therapy or initiating specific treatment for the high cholesterol or diabetes (the high blood sugar).

Many studies are underway to determine: How frequently these biochemical problems occur. Whether they will place patients at increased risk for heart disease or the complications of diabetes in the future. How to best monitor for and treat these biochemical abnormalities when they develop.

In addition, there is a great deal of interest in defining whether these metabolic abnormalities are linked to the physical changes described above. If so, treating the lipid and glucose problems may represent a strategy for preventing or managing the physical changes.

In conclusion, physical (morphologic) and biochemical (metabolic) changes associated with HIV disease and antiretroviral therapy remain poorly understood. Clinicians need to be honest and up front with patients about these unknowns. However, we should avoid the temptation to assume a cause and effect relationship between any associations. Although the physical abnormalities (manifestations) are often devastating for patients, we must not lose perspective. Antiretroviral therapy can and has saved lives. These known benefits of treatment need to be considered along with all potential toxicities when deciding upon the ideal time to initiate therapy for HIV in any given individual.