Gender-Specific Issues in the Metabolic Complications of HIV Disease and Its Treatment

This chapter focusses on the medical aspects in which gender affects the metabolic complications of HIV disease. It summarizes some of the current descriptions and controversies regarding the metabolic complications of HIV and HIV therapy, specifically lipodystrophy, glucose intolerance, hyperlipidemia, lactate acidosis, and bone demineralization. The term lipodystrophy is often used to describe any alteration in the distribution of adipose tissue in individuals with HIV. The prevalence of fat redistribution has been reported in 2-84% of individuals with HIV. In addition to initial reports describing these observations in male patients, these findings have also been specifically described in women. Changes in body habitus have been reported in a study on 21 women undergoing highly active antiretroviral therapy (HAART). The development of dyslipidemia has been associated with HIV disease and its therapy. The question regarding whether individuals with HIV are at risk of developing coronary heart disease (CHD) and subsequent myocardial infarction (MI) remains unanswered. Changes in bone mineralization have been reported to be more prevalent in individuals with HIV than in individuals without HIV.