Abstract：
HIV infection has been controlled only since the introduction of triple therapy in 1996, combining, as antiretroviral agents, two nucleoside reverse transcriptase inhibitors (NRTIs) and one protease inhibitor (PI). However, among the NRTIs, the thymidine analogues stavudine and zidovudine led to lipoatrophy, either generalized or associated with visceral fat hypertrophy and buffalo hump. These molecules also increased insulin resistance and the prevalence of diabetes. They were replaced by other NRTIs or non-NRTIs (NNRTIs) that were considered to be free of adipose tissue (AT) toxicity. More recently, the NRTI tenofovir disoproxyfumarate (TDF) and the NNRTI efavirenz have been associated with inhibition of fat gain but not with clear lipoatrophy. Otherwise, the use of PIs led to a phenotype of trunk fat hypertrophy associated with cardiometabolic complications. To avoid their adverse effects, PIs have recently been replaced by a new class of antiretrovirals, the integrase inhibitors (INSTIs), which are well tolerated and effective in controlling HIV. However, this class has been associated with global weight gain, which may be important and concerning for some people living with HIV (PWH). Also, in the NRTI class, TDF has often been replaced by tenofovir alafenamide (TAF) due to bone and renal toxicities, and TAF has been associated with global fat gain. The cardiometabolic consequences of INTIs and TAF are primarily related to the associated weight gain. In the global obesogenic worldwide context, PWH are gaining weight as well in relation to poor health life conditions. Taking in charge obesity uses the same strategies as those used in the general population.
摘要：
自1996年引入三联疗法以来，艾滋病毒感染才得到控制，作为抗逆转录病毒药物，两种核苷逆转录酶抑制剂(NRTIs)和一种蛋白酶抑制剂(PI)。然而,在NRTIs中,胸苷类似物司他夫定和齐多夫定导致脂肪萎缩，全身或与内脏脂肪肥大和水牛驼峰有关。这些分子还增加了胰岛素抵抗和糖尿病的患病率。它们被认为没有脂肪组织(AT)毒性的其他NRTI或非NRTI(NNRTI)替代。最近,NRTI替诺福韦富马酸二丙酯（TDF）和NNRTI法韦伦与抑制脂肪增加有关，但与明显的脂肪萎缩无关。否则,使用PI导致与心脏代谢并发症相关的躯干脂肪肥大表型.为了避免其不利影响，PI最近被一类新的抗逆转录病毒药物所取代，整合酶抑制剂（INSTIs），这是很好的耐受性和有效的控制艾滋病毒。然而,这个类与全球体重增加有关，这对于一些艾滋病毒携带者(PWH)来说可能是重要和令人担忧的。此外，在NRTI类，由于骨骼和肾脏毒性，TDF经常被替诺福韦艾拉酚胺（TAF）取代，TAF与全球脂肪增加有关。INTI和TAF的心脏代谢后果主要与相关的体重增加有关。在全球肥胖的全球背景下，PWH与不良健康生活条件有关的体重也在增加。负责肥胖使用与一般人群相同的策略。
