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Purpose Of Review: As advances in antiretroviral therapy for people with HIV (PWH) have prolonged lifespans, prevalence of aging and obesity related metabolic disorders have increased. The purpose of this review is to summarize recent research assessing sex differences in metabolic disorders among PWH, including weight gain/obesity, steatotic liver disease, insulin resistance/diabetes, dyslipidemia, bone loss/osteoporosis, and sarcopenia.

Recent Findings: A growing body of evidence shows that women with HIV are at increased risk of developing metabolic disorders compared to men, including body weight gain and obesity, type 2 diabetes mellitus, dyslipidemia, bone loss, and sarcopenia, while men with HIV are at higher risk for hepatosteatosis and hepatic fibrosis.

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Relationships Between Hepatic Steatosis and Frailty Differ by HIV Serostatus.

J Acquir Immune Defic Syndr

October 2024

Division of Infectious Diseases, UTHealth Houston, Houston, TX.

Background: Frailty is associated with obesity-related comorbidities, but the relationship with nonalcoholic fatty liver disease (NAFLD) in people with HIV has been incompletely described. Our objective was to assess the associations between NAFLD and frailty.

Methods: Cross-sectional and longitudinal analysis of men in the Multicenter AIDS Cohort Study.

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Background: The implications of bariatric surgery (BS) on virologic and metabolic outcomes in people with human immunodeficiency virus (HIV; PWH) on antiretroviral therapy (ART) are unknown.

Methods: Here, we report a retrospective analysis up to 18 months post-BS in PWH from the AIDS Therapy evaluation in The Netherlands (ATHENA) cohort with data from all dutch HIV treating Centers. Primary end points were a confirmed virologic failure (2 consecutive HIV-RNA measurements >200 copies/mL) and the percentage of patients who achieved >20% total body weight loss up to 18 months post-BS.

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Article Synopsis
  • The study examined the link between obesity-related genetic variants and weight gain in people with HIV starting antiretroviral therapy (ART).
  • Over 1,000 participants showed an average weight gain of about 2.90 kg after 96 weeks, influenced by factors like female gender and previous AIDS diagnoses.
  • Certain genetic variants (ZC3H4 rs3810291 and BCDIN3D/FAIM2 rs7138803) were significantly associated with greater weight gain, suggesting genetics could impact ART-related weight changes.
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Objective: People living with HIV have high rates of obesity and obesity-related comorbidities. Our study sought to evaluate weight trajectory in a retrospective cohort of people living with HIV and matched HIV-negative veterans (controls) and to evaluate risk factors for weight gain.

Methods: This was a retrospective database analysis of data extracted from the VA Corporate Data Warehouse that included people living with HIV (n = 22 421) and age-matched HIV-negative controls (n = 63 072).

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