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JUNE 14, 2023
HIV and Weight Stigma
By Milena Murray, PharmD, MSc, BCIDP, AAHIVP, FCCP
HIV-associated wasting has declined with access to antiretrovirals (ARVs). However, weight gain and metabolic syndrome continue to increase across people with HIV.1 Access to more effective and tolerable ARVs has increased virologic suppression and immunologic recovery, leading to increased life span.1 The benefit of ARVs on morbidity and mortality outweighs the risk for potential side effects from ARVs. However, as people with HIV age and life span increases, the effect of weight gain and other metabolic abnormalities must be considered.2
Weight gain associated with HIV includes the “return to health” phenomenon and the effects of ARVs.1,3 Older ARVs were associated with lipodystrophy.2 Weight gain and the impact of ARVs on insulin resistance contribute to developing type 2 diabetes in people with HIV.2,4,5 Metabolic syndrome, a cluster of risk factors for cardiovascular diseases and type 2 diabetes, also may occur.1 In addition, inflammation linked to abdominal obesity may contribute to neurocognitive impairment.1 The impact of immune dysfunction and dysregulation on adipose tissue affects health outcomes.6 Individuals at lower weight have differing adipose tissue immune function and inflammation compared with those at higher weight and at higher weight with HIV.6 Metabolic abnormalities may lead to nonalcoholic fatty liver disease. The effects of gestational weight gain in people who have HIV must also be considered.7,8 Blood pressure also has been affected during the first year of ARV therapy and beyond.3,9
Continue reading... https://www.idse.net/ARTclass/Article/06-23/HIV-and-Weight-Stigma/70467
"Reproduced with permission - Infectious Disease Special Edition (IDSE)"
Infectious Disease Special Edition (IDSE)
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