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Inflammation and Metabolic Complications in HIV

  • Complications of Antiretroviral Therapy (GA McComsey, Section Editor)
  • Published:
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Abstract

Purpose of Review

We aim to provide an in-depth review of recent literature highlighting the role of inflammation involving the adipose tissue, liver, skeletal muscles, and gastrointestinal tract in the development of metabolic complications among persons living with HIV (PLWH).

Recent Findings

Recent studies in PLWH have demonstrated a significant association between circulating inflammatory markers and development of insulin resistance and metabolic complications. In adipose tissue, pro-inflammatory cytokine expression inhibits adipocyte insulin signaling, which alters lipid and glucose homeostasis. Increased lipolysis and lipogenesis elevate levels of circulating free fatty acids and promote ectopic fat deposition in liver and skeletal muscles. This leads to lipotoxicity characterized by a pro-inflammatory response with worsening insulin resistance. Finally, HIV is associated with gastrointestinal tract inflammation and changes in the gut microbiome resulting in reduced diversity, which is an additional risk factor for diabetes.

Summary

Metabolic complications in PLWH are in part due to chronic, multisite tissue inflammation resulting in dysregulation of glucose and lipid trafficking, utilization, and storage.

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Funding

This work was supported in part by the NIH-funded Tennessee Center for AIDS Research (P30 AI110527).

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  1. Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, A2200-MCN, 1161 21st Avenue South, Nashville, TN, 37232-2582, USA

    Kassem Bourgi, Celestine Wanjalla & John R. Koethe

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John R. Koethe receives research funding from Gilead Pharmaceuticals. Kassem Bourgi and Celestine Wanjalla declare that they have no competing interests.

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This article is part of the Topical Collection on Complications of Antiretroviral Therapy

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Bourgi, K., Wanjalla, C. & Koethe, J.R. Inflammation and Metabolic Complications in HIV. Curr HIV/AIDS Rep 15, 371–381 (2018). https://doi.org/10.1007/s11904-018-0411-2

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