Issue: 2003 > December > review

Antiretroviral therapy in HIV patients: aspects of metabolic complications and mitochondrial toxici

H.J.M. ter Hofstede, D.M. Burger, P.P. Koopmans


Since the introduction of highly active antiretroviral
therapy (HAART) in HIV-infected patients, morbidity
and mortality due to HIV infection have dramatically
decreased. Although resistance to antiretroviral therapy
is an important issue, toxicity is becoming an even more
important problem. In the ATHENA cohort (a cohort of
around 3000 HIV patients in the Netherlands), the main
reason to switch antiretroviral therapy is toxicity: this is
44 to 58% in patients on their first regimen and 56% on
subsequent regimens. Since HIV cannot be cured,
chronic therapy is needed to suppress HIV replication;
therefore the risk for adverse events may increase. The
benefits of HAART have led to a great number of HIV
patients receiving antiretroviral therapy.
In this review we will discuss two major groups of
antiretroviral therapy-related toxicity: the lipodystrophy/
lipoatrophy syndrome with metabolic changes and
mitochondrial toxicity.