[Consensus statement on metabolic disorders and cardiovascular risks in patients with human immunodeficiency virus]

Abstract

Objective: This consensus document is an update of metabolic disorders and cardiovascular risk (CVR) guidelines for HIV-infected patients.

Methods: This document has been approved by an expert panel of GEAM, SPNS and GESIDA after reviewing the results of efficacy and safety of clinical trials, cohort and pharmacokinetic studies published in biomedical journals (PubMed and Embase) or presented in medical scientific meetings. Recommendation strength and the evidence in which they are supported are based on the GRADE system.

Results: A healthy lifestyle is recommended, no smoking and at least 30min of aerobic exercise daily. In diabetic patients the same treatment as non-HIV infected patients is recommended. HIV patients with dyslipidemia should be considered as high CVR, thus its therapeutic objective is an LDL less than 100mg/dL. The antihypertensive of ACE inhibitors and ARAII families are better tolerated and have a lower risk of interactions. In HIV-patients with diabetes or metabolic syndrome and elevated transaminases with no defined etiology, the recommended is to rule out a hepatic steatosis Recommendations for action in hormone alterations are also updated.

Conclusions: These new guidelines update previous recommendations regarding all those metabolic disorders involved in CVR. Hormone changes and their management and the impact of metabolic disorders on the liver are also included.

Keywords: Alteraciones metabólicas; Cardiovascular risk; Human immunodeficiency virus infection; Infección por el virus de la inmunodeficiencia humana; Metabolic disorders; Riesgo cardiovascular.