ReviewToxicologic pathology2009
The role of protease inhibitors in the pathogenesis of HIV-associated lipodystrophy: cellular mechanisms and clinical implications.
Review in Toxicologic pathology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
39 citing papers in PubMed, 1 synthesis or guideline pooled it, 97 citations in OpenAlex.
- Characterization and risk stratification of coronary artery disease in people living with HIV: a global systematic review.Frontiers in cardiovascular medicine · 2025Pooled it
- Effects of once-daily darunavir/ritonavir versus atazanavir/ritonavir on insulin sensitivity in HIV-infected persons over 48 weeks: results of an exploratory substudy of METABOLIK, a phase 4, randomized trial.HIV clinical trials · 2016Trial
- Metabolic effects of darunavir/ritonavir versus atazanavir/ritonavir in treatment-naive, HIV type 1-infected subjects over 48 weeks.AIDS research and human retroviruses · 2012Trial
- Review
- The Fatty Pancreas: Current Evidence, Treatment Implications, and Future Directions.Gastro hep advances · 2026Review
- The heart of the matter: modeling HIV-associated cardiovascular comorbidities in nonhuman primate models.Frontiers in cellular and infection microbiology · 2025Review
- Adipose Tissue Dysfunction and Energy Balance Paradigms in People Living With HIV.Endocrine reviews · 2024Review
- Molecular Factors and Pathways of Hepatotoxicity Associated with HIV/SARS-CoV-2 Protease Inhibitors.International journal of molecular sciences · 2023Review
- Fatty infiltration of the pancreas: a systematic concept analysis.Frontiers in medicine · 2023Review
- Co-administration of rimonabant prevents glucose intolerance in Sprague-Dawley rats treated chronically with lopinavir/ritonavir and zidovudine: an experimental study design.The Pan African medical journal · 2023Article
- Weight of Clinical and Social Determinants of Metabolic Syndrome in People Living with HIV.Viruses · 2022Article
- Expert Panel Review on Nonalcoholic Fatty Liver Disease in Persons With Human Immunodeficiency Virus.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2022Review
- Dyspnea and Pulmonary Function Among Participants in the Multicenter AIDS Cohort Study Using Protease Inhibitors: A Cross-Sectional Study.AIDS research and human retroviruses · 2022Article
- Discordant Liver Fibrosis Predictors in Virologically Suppressed People Living with HIV without Hepatitis Virus Infection.Diagnostics (Basel, Switzerland) · 2021Article
- Liver Fibrosis during Antiretroviral Treatment in HIV-Infected Individuals. Truth or Tale?Cells · 2021Review
- Drugs Affecting Body Weight, Body Fat Distribution, and Metabolic Function-Mechanisms and Possible Therapeutic or Preventive Measures: an Update.Current obesity reports · 2021Review
- Inhibition of osteoblast differentiation by ritonavir.Biomedical reports · 2018Article
- Increased trunk fat along with decreased peripheral fat as an important predictor of hypertriglyceridaemia & hypercholesterolaemia in Indians with HIV infection.The Indian journal of medical research · 2018Article
- Examining Relationships between Metabolism and Persistent Inflammation in HIV Patients on Antiretroviral Therapy.Mediators of inflammation · 2018Review
- Coronary Artery Disease in HIV-Infected Patients: Downside of Living Longer.Current atherosclerosis reports · 2017Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 6 institutions in 1 country.
Funding
Abstract
Metabolic complications associated with HIV infection and treatment frequently present as a relative lack of peripheral adipose tissue associated with dyslipidemia and insulin resistance. In this review we explain the connection between abnormalities of intermediary metabolism, observed either in vitro or in vivo, and this group of metabolic effects. We review molecular mechanisms by which the HIV protease inhibitor (PI) class of drugs may affect the normal stimulatory effect of insulin on glucose and fat storage. We then propose that both chronic inflammation from HIV infection and treatment with some drugs in this class trigger cellular homeostatic stress responses with adverse effects on intermediary metabolism. The physiologic outcome is such that total adipocyte storage capacity is decreased, and the remaining adipocytes resist further fat storage. The excess circulating and dietary lipid metabolites, normally "absorbed" by adipose tissue, are deposited ectopically in lean (muscle and liver) tissue, where they impair insulin action. This process leads to a pathologic cycle of lipotoxicity and lipoatrophy and a clinical phenotype of body fat distribution with elevated waist-to-hip ratio similar to the metabolic syndrome.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.