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This condition involved subcutaneous fat atrophy; abdominal fat hypertrophy; and, in some cases, lipomatosis. It was also associated with systemic metabolic disturbances, primarily insulin resistance and dyslipidemia. Following the replacement of certain antiretroviral drugs, particularly the thymidine-analog reverse transcriptase inhibitors stavudine and zidovudine, with less toxic alternatives, the incidences of lipoatrophy and lipomatosis significantly declined. However, lipodystrophy resulting from first-generation antiretroviral therapy does not always resolve after switching to newer agents. Although the widespread use of modern antiretroviral drugs\u2014especially integrase strand transfer inhibitors and non-lipoatrophic reverse transcriptase inhibitors such as tenofovir alafenamide\u2014has reduced the incidences of severe forms of lipodystrophy, these regimens are not entirely free of adipose tissue-related effects. Notably, they are associated with weight gain that resembles common obesity and can have adverse cardiometabolic consequences. Recent evidence also suggests the hypertrophy of specific fat depots, such as epicardial and perivascular adipose tissue, in PLWH on last-generation treatments, potentially contributing to increased cardiovascular risk. This evolving landscape underscores the persistent vulnerability of PLWH to adipose tissue alterations. While these morphological changes may not be as pronounced as those seen in classic HIV-associated lipodystrophy, they can still pose significant health risks. The continued optimization of treatment regimens and the vigilant monitoring of adipose tissue alterations and metabolic status remain essential strategies to improve the health of PLWH.<\/jats:p>","DOI":"10.3390\/ijms26146546","type":"journal-article","created":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T04:18:11Z","timestamp":1751948291000},"page":"6546","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Lipodystrophy in HIV: Evolving Challenges and Unresolved Questions"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7968-4190","authenticated-orcid":false,"given":"Marta","family":"Giralt","sequence":"first","affiliation":[{"name":"Department of Biochemistry and Molecular Biomedicine, Institute of Biomedicine of the University of Barcelona (IBUB), 08028 Barcelona, Spain"},{"name":"CIBER \u201cFisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n\u201d (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1138-5770","authenticated-orcid":false,"given":"Pere","family":"Domingo","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Quesada-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Biomedicine, Institute of Biomedicine of the University of Barcelona (IBUB), 08028 Barcelona, Spain"},{"name":"CIBER \u201cFisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n\u201d (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1108-230X","authenticated-orcid":false,"given":"Rub\u00e9n","family":"Cereijo","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Biomedicine, Institute of Biomedicine of the University of Barcelona (IBUB), 08028 Barcelona, Spain"},{"name":"CIBER \u201cFisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n\u201d (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1266-9142","authenticated-orcid":false,"given":"Francesc","family":"Villarroya","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Biomedicine, Institute of Biomedicine of the University of Barcelona (IBUB), 08028 Barcelona, Spain"},{"name":"CIBER \u201cFisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n\u201d (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/j.beem.2010.12.001","article-title":"Adipose tissue biology and HIV-infection","volume":"25","author":"Giralt","year":"2011","journal-title":"Best Pract. Res. Clin. Endocrinol. Metab."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1038\/s41572-020-0181-1","article-title":"HIV and antiretroviral therapy-related fat alterations","volume":"6","author":"Koethe","year":"2020","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1210\/endrev\/bnad028","article-title":"Adipose Tissue Dysfunction and Energy Balance Paradigms in People Living with HIV","volume":"45","author":"Agarwal","year":"2024","journal-title":"Endocr. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/COH.0000000000000674","article-title":"Recent data on adipose tissue, insulin resistance, diabetes and dyslipidaemia in antiretroviral therapy controlled HIV-infected persons","volume":"16","author":"Capeau","year":"2021","journal-title":"Curr. Opin. HIV AIDS"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.anplas.2024.10.006","article-title":"Current status and perspectives in the treatment of facial lipoatrophy in HIV-positive patients in 2024","volume":"70","author":"Tilhet","year":"2025","journal-title":"Ann. Chir. Plast. Esthet."},{"key":"ref_6","first-page":"112","article-title":"Fat redistribution syndromes associated with HIV-1 infection and combination antiretroviral therapy","volume":"14","author":"Domingo","year":"2012","journal-title":"AIDS Rev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1097\/00126334-200308150-00004","article-title":"HIV Lipodystrophy Case Definition Study Group. An objective lipodystrophy severity grading scale derived from the lipodystrophy case definition score","volume":"33","author":"Carr","year":"2003","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1097\/00002030-200305020-00005","article-title":"Prospective evaluation of the effects of antiretroviral therapy on body composition in HIV-1-infected men starting therapy","volume":"17","author":"Mallon","year":"2003","journal-title":"AIDS"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1093\/jac\/dki062","article-title":"Therapeutic approaches to combating lipoatrophy: Do they work?","volume":"55","author":"Martin","year":"2005","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1093\/cid\/ciy083","article-title":"Metabolic Effects of Preexposure Prophylaxis with Coformulated Tenofovir Disoproxil Fumarate and Emtricitabine","volume":"67","author":"Glidden","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1111\/hiv.12210","article-title":"Switching from zidovudine\/lamivudine to tenofovir\/emtricitabine improves fat distribution as measured by fat mass ratio","volume":"16","author":"Ribera","year":"2015","journal-title":"HIV Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/COH.0000000000000833","article-title":"Recent data on the role of antiretroviral therapy in weight gain and obesity in persons living with HIV","volume":"19","author":"Capeau","year":"2024","journal-title":"Curr. Opin. HIV AIDS"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"19553","DOI":"10.7448\/IAS.17.4.19553","article-title":"Long-term fat redistribution in ARV-na\u00efve HIV+ patients initiating a non-thymidine containing regimen in clinical practice","volume":"17","author":"Ferrer","year":"2014","journal-title":"J. Int. AIDS Soc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2805","DOI":"10.1097\/QAD.0000000000001248","article-title":"Long-term body composition changes in antiretroviral-treated HIV-infected individuals","volume":"30","author":"Grant","year":"2016","journal-title":"AIDS"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1016\/S0140-6736(97)11443-X","article-title":"\u201cBuffalo hump\u201d in men with HIV-1 infection","volume":"351","author":"Lo","year":"1998","journal-title":"Lancet"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1097\/QAI.0b013e31804a85b0","article-title":"Prevalence of and risk factors for pubic lipoma development in HIV-infected persons","volume":"45","author":"Guaraldi","year":"2007","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Cereijo, R., Gallego-Escuredo, J.M., Moure, R., Villarroya, J., Domingo, J.C., Fontdevila, J., Mart\u00ednez, E., Guti\u00e9rrez, M.M., Mateo, M.G., and Giralt, M. (2015). The Molecular Signature of HIV-1-Associated Lipomatosis Reveals Differential Involvement of Brown and Beige\/Brite Adipocyte Cell Lineages. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0136571"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e13","DOI":"10.1086\/426686","article-title":"Facial lipohypertrophy in HIV-infected subjects who underwent autologous fat tissue transplantation","volume":"40","author":"Guaraldi","year":"2005","journal-title":"Clin. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1097\/QAD.0b013e3282f56b40","article-title":"Differential gene expression indicates that \u2018buffalo hump\u2019 is a distinct adipose tissue disturbance in HIV-1-associated lipodystrophy","volume":"22","author":"Guallar","year":"2008","journal-title":"AIDS"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2443","DOI":"10.1016\/j.ajpath.2011.07.049","article-title":"LMNA mutations induce a non-inflammatory fibrosis and a brown fat-like dystrophy of enlarged cervical adipose tissue","volume":"179","author":"Cervera","year":"2011","journal-title":"Am. J. Pathol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Bourgeois, C., Gorwood, J., Olivo, A., Le Pelletier, L., Capeau, J., Lambotte, O., B\u00e9r\u00e9ziat, V., and Lagathu, C. (2021). Contribution of Adipose Tissue to the Chronic Immune Activation and Inflammation Associated with HIV Infection and Its Treatment. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.670566"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1038\/s41580-018-0093-z","article-title":"Adipogenesis and metabolic health","volume":"20","author":"Ghaben","year":"2019","journal-title":"Nat. Rev. Mol. Cell. Biol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1784","DOI":"10.1172\/JCI29126","article-title":"Adiponectin and adiponectin receptors in insulin resistance, diabetes, and the metabolic syndrome","volume":"116","author":"Kadowaki","year":"2006","journal-title":"J. Clin. Investig."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1210\/jc.2002-021600","article-title":"Regulation of adiponectin in human immunodeficiency virus-infected patients: Relationship to body composition and metabolic in-dices","volume":"88","author":"Tong","year":"2003","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1177\/135965350400900607","article-title":"Antiretroviral drugs with adverse effects on adipocyte lipid metabolism and survival alter the expression and secretion of proinflammatory cytokines and adiponectin in vitro","volume":"9","author":"Lagathu","year":"2004","journal-title":"Antivir. Ther."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1177\/135965350701200407","article-title":"Some HIV antiretrovirals increase oxidative stress and alter chemokine, cytokine or adiponectin production in human adipocytes and macrophages","volume":"12","author":"Lagathu","year":"2007","journal-title":"Antivir. Ther."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1177\/135965350501000202","article-title":"Altered adipokine response in murine 3T3-F442A adipocytes treated with protease inhibitors and nucleoside reverse transcriptase inhibitors","volume":"10","author":"Jones","year":"2005","journal-title":"Antivir. Ther."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"545","DOI":"10.2174\/157016210793499222","article-title":"Differential effects of efavirenz and lopinavir\/ritonavir on human adipocyte differentiation, gene expression and release of adipokines and pro-inflammatory cytokines","volume":"8","author":"Domingo","year":"2010","journal-title":"Curr. HIV Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"92","DOI":"10.11599\/germs.2015.1076","article-title":"Leptin expression in HIV-infected patients during antiretroviral therapy","volume":"5","author":"Tiliscan","year":"2015","journal-title":"Germs"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"3371","DOI":"10.2174\/138161210793563527","article-title":"Lipotoxicity on the basis of metabolic syndrome and lipodystrophy in HIV-1-infected patients under antiretroviral treatment","volume":"16","author":"Giralt","year":"2010","journal-title":"Curr. Pharm. Des."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.bbalip.2009.09.018","article-title":"Drug-induced lipotoxicity: Lipodystrophy associated with HIV-1 infection and antiretroviral treatment","volume":"1801","author":"Villarroya","year":"2010","journal-title":"Biochim. Biophys. Acta"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1152\/japplphysiol.00797.2005","article-title":"Increased intramyocellular lipid accumulation in HIV-infected women with fat redistribution","volume":"100","author":"Torriani","year":"2006","journal-title":"J. Appl. Physiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2183","DOI":"10.1097\/00002030-200211080-00011","article-title":"Increased fat accumulation in the liver in HIV-infected patients with antiretroviral therapy-associated lipodystrophy","volume":"16","author":"Sutinen","year":"2002","journal-title":"AIDS"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"S63","DOI":"10.1093\/infdis\/jiaa245","article-title":"Myocardial Steatosis Among Antiretroviral Therapy-Treated People with Human Immunodeficiency Virus Participating in the REPRIEVE Trial","volume":"222","author":"Neilan","year":"2020","journal-title":"J. Infect. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1093\/cid\/ciz258","article-title":"The Impact of Human Immunodeficiency Virus Infection on Gut Microbiota \u03b1-Diversity: An Individual-level Meta-analysis","volume":"70","author":"Tuddenham","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1038\/nm1511","article-title":"Microbial translocation is a cause of systemic immune activation in chronic HIV infection","volume":"12","author":"Brenchley","year":"2006","journal-title":"Nat. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1097\/QAI.0000000000002229","article-title":"Intestinal Dysbiosis and Markers of Systemic Inflammation in Viscerally and Generally Obese Persons Living with HIV","volume":"83","author":"Gogokhia","year":"2020","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1097\/QAD.0000000000001366","article-title":"Low abundance of colonic butyrate-producing bacteria in HIV infection is associated with microbial translocation and immune activation","volume":"31","author":"Dillon","year":"2017","journal-title":"AIDS"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1007\/s00428-002-0667-0","article-title":"Ultra-structural features of highly active antiretroviral therapy-associated partial lipodystrophy","volume":"441","author":"Lloreta","year":"2002","journal-title":"Virchows Arch."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1177\/135965350400900412","article-title":"Altered fat differentiation and adipocytokine expression are interrelated and linked to morphological changes and insulin resistance in HIV-1-infected lipodystrophic patients","volume":"9","author":"Jan","year":"2004","journal-title":"Antivir. Ther."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1097\/QAI.0000000000000001","article-title":"CD8 T-cell activation is associated with lipodystrophy and visceral fat accumulation in antiretroviral therapy-treated virologically suppressed HIV-infected patients","volume":"64","author":"Guaraldi","year":"2013","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_42","unstructured":"Huhyaniemi, I., and Martini, L. (2019). Lipodystrophies. Encyclopedia of Endocrine Diseases, Elsevier. [2nd ed.]."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.tips.2004.12.005","article-title":"Lipodystrophy associated with highly active anti-retroviral therapy for HIV infection: The adipocyte as a target of anti-retroviral-induced mitochondrial toxicity","volume":"26","author":"Villarroya","year":"2005","journal-title":"Trends Pharmacol. Sci."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2127","DOI":"10.1097\/00002030-200411050-00004","article-title":"The HIV-1 nucleoside reverse transcriptase inhibitors stavudine and zidovudine alter adipocyte functions in vitro","volume":"18","author":"Caron","year":"2004","journal-title":"AIDS"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1128\/AAC.00914-09","article-title":"Mitochondrial DNA depletion and respiratory chain activity in primary human subcutaneous adipocytes treated with nucleoside analogue reverse transcriptase inhibitors","volume":"54","author":"Stankov","year":"2010","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1097\/QAI.0b013e31823daff3.","article-title":"Mitochondrial DNA haplogroups and incidence of lipodystrophy in HIV-infected patients on long-term antiretroviral therapy","volume":"59","author":"Nasi","year":"2012","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1097\/QAI.0b013e31829bdb67","article-title":"Differentially altered molecular signature of visceral adipose tissue in HIV-1-associated lipodystrophy","volume":"64","author":"Villarroya","year":"2013","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"E315","DOI":"10.1152\/ajpendo.90486.2008","article-title":"Depot-specific adipocyte cell lines reveal differential drug-induced responses of white adipocytes--relevance for partial lipodystrophy","volume":"296","author":"Kovsan","year":"2009","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1038\/sj.ijo.0803698","article-title":"Lipodystrophy in HIV 1-infected patients: Lessons for obesity research","volume":"31","author":"Villarroya","year":"2007","journal-title":"Int. J. Obes."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"R185","DOI":"10.1530\/EJE-13-0967","article-title":"Metabolic and body composition effects of newer antiretrovirals in HIV-infected patients","volume":"170","author":"Srinivasa","year":"2014","journal-title":"Eur. J. Endocrinol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1038\/72807","article-title":"LMNA, encoding lamin A\/C, is mutated in partial lipodystrophy","volume":"24","author":"Shackleton","year":"2000","journal-title":"Nat. Genet."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1210\/jc.2015-3993","article-title":"Dysfunctional Subcutaneous Fat with Reduced Dicer and Brown Adipose Tissue Gene Expression in HIV-Infected Patients","volume":"10","author":"Torriani","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e150399","DOI":"10.1172\/jci.insight.150399","article-title":"Altered pattern of circulating miRNAs in HIV lipodystrophy perturbs key adipose differentiation and inflammation pathways","volume":"6","author":"Srinivasa","year":"2021","journal-title":"JCI Insight"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2537","DOI":"10.1097\/00002030-200311210-00019","article-title":"In vitro infection of human primary adipose cells with HIV-1: A reassessment","volume":"17","author":"Munier","year":"2003","journal-title":"AIDS"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1097\/QAD.0000000000000599","article-title":"Human adipose tissue as a reservoir for memory CD4+ T cells and HIV","volume":"29","author":"Couturier","year":"2015","journal-title":"AIDS"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Damouche, A., Lazure, T., Avettand-F\u00e8no\u00ebl, V., Huot, N., Dejucq-Rainsford, N., Satie, A.P., M\u00e9lard, A., David, L., Gommet, C., and Ghosn, J. (2015). Adipose Tissue Is a Neglected Viral Reservoir and an Inflammatory Site during Chronic HIV and SIV Infection. PLoS Pathog., 11.","DOI":"10.1371\/journal.ppat.1005153"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1007\/s11904-018-0378-z","article-title":"HIV Persistence in Adipose Tissue Reservoirs","volume":"15","author":"Couturier","year":"2018","journal-title":"Curr. HIV\/AIDS Rep."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1097\/QAD.0000000000002168","article-title":"Impact of HIV\/simian immunodeficiency virus infection and viral proteins on adipose tissue fibrosis and adipogenesis","volume":"33","author":"Gorwood","year":"2019","journal-title":"AIDS"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Gorwood, J., Ejlalmanesh, T., Bourgeois, C., Mantecon, M., Rose, C., Atlan, M., Desjardins, D., Le Grand, R., F\u00e8ve, B., and Lambotte, O. (2020). SIV Infection and the HIV Proteins Tat and Nef Induce Senescence in Adipose Tissue and Human Adipose Stem Cells, Resulting in Adipocyte Dysfunction. Cells, 9.","DOI":"10.3390\/cells9040854"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"55","DOI":"10.4161\/adip.29852","article-title":"Viral mechanisms of adipose dysfunction: Lessons from HIV-1 Vpr","volume":"4","author":"Agarwal","year":"2014","journal-title":"Adipocyte"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"529","DOI":"10.3851\/IMP2021","article-title":"HIV-1 Tat protein impairs adipogenesis and induces the expression and secretion of proinflammatory cytokines in human SGBS adipocytes","volume":"17","author":"Domingo","year":"2012","journal-title":"Antivir. Ther."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1177\/135965350601100610","article-title":"HIV-1 infection alters gene expression in adipose tissue, which contributes to HIV- 1\/HAART-associated lipodystrophy","volume":"11","author":"Giralt","year":"2006","journal-title":"Antivir. Ther."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1093\/cid\/ciz999","article-title":"Weight Gain Following Initiation of Antiretroviral Therapy: Risk Factors in Randomized Comparative Clinical Trials","volume":"71","author":"Sax","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1056\/NEJMoa1902824","article-title":"Dolutegravir plus Two Different Prodrugs of Tenofovir to Treat HIV","volume":"381","author":"Venter","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1093\/jac\/dkad007","article-title":"Striking differences in weight gain after cART initiation depending on early or advanced presentation: Results from the ANRS CO4 FHDH cohort","volume":"78","author":"Grabar","year":"2023","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e471","DOI":"10.1093\/cid\/ciaa177","article-title":"Risk Factors for Weight Gain Following Switch to Integrase Inhibitor-Based Antiretroviral Therapy","volume":"71","author":"Lake","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1097\/COH.0000000000000834","article-title":"The pathogenesis of obesity in people living with HIV","volume":"19","author":"Bailin","year":"2024","journal-title":"Curr. Opin. HIV AIDS"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1970","DOI":"10.1038\/s41366-020-0551-5","article-title":"Potential role of the melanocortin signaling system interference in the excess weight gain associated to some antiretroviral drugs in people living with HIV","volume":"44","author":"Domingo","year":"2020","journal-title":"Int. J. Obes."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"e478","DOI":"10.1210\/clinem\/dgad411","article-title":"Weight Gain After HIV Therapy Initiation: Pathophysiology and Implications","volume":"109","author":"Chandiwana","year":"2024","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Ngono Ayissi, K., Gorwood, J., Le Pelletier, L., Bourgeois, C., Beaup\u00e8re, C., Auclair, M., Foresti, R., Motterlini, R., Atlan, M., and Bar-rail-Tran, A. (2022). Inhibition of Adipose Tissue Beiging by HIV Integrase Inhibitors, Dolutegravir and Bictegravir, Is Associated with Adipocyte Hypertrophy, Hypoxia, Elevated Fibrosis, and Insulin Resistance in Simian Adipose Tissue and Human Adipocytes. Cells, 11.","DOI":"10.3390\/cells11111841"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"e549","DOI":"10.1093\/cid\/ciaa259","article-title":"The Integrase Inhibitors Dolutegravir and Raltegravir Exert Proadipogenic and Profibrotic Effects and Induce Insulin Resistance in Human\/Simian Adipose Tissue and Human Adipocytes","volume":"71","author":"Gorwood","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"120948","DOI":"10.1016\/j.lfs.2022.120948","article-title":"Differential effects of dolutegravir, bictegravir and raltegravir in adipokines and inflammation markers on human adipocytes","volume":"308","author":"Domingo","year":"2022","journal-title":"Life Sci."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Quesada-L\u00f3pez, T., Cereijo, R., Blasco-Roset, A., Mestres-Arenas, A., Prieto, P., Domingo, J.C., Villarroya, F., Domingo, P., and Giralt, M. (2024). Divergent effects of the antiretroviral drugs, dolutegravir, tenofovir alafenamide, and tenofovir disoproxil fumarate, on human adipocyte function. Biochem. Pharmacol., 220.","DOI":"10.1016\/j.bcp.2023.116010"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1097\/QAD.0000000000003455","article-title":"Adipocyte differentiation of 3T3-L1 cells under tenofovir alafenamide, tenofovir disoproxil fumarate, and integrase strand transfer inhibitors selective challenge: An in-vitro model","volume":"37","author":"Perna","year":"2023","journal-title":"AIDS"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1111\/hiv.13488","article-title":"Weight gain following the single substitution of tenofovir disoproxil fumarate by tenofovir alafenamide in HIV-infected people from the French Dat\u2019AIDS cohort: A propensity score-matched analysis","volume":"24","author":"Hocqueloux","year":"2023","journal-title":"HIV Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"106151","DOI":"10.1016\/j.antiviral.2025.106151","article-title":"Tenofovir alafenamide promotes weight gain and impairs fatty acid metabolism-related signaling pathways in visceral fat tissue compared to tenofovir disoproxil fumarate","volume":"237","author":"Dulion","year":"2025","journal-title":"Antivir. Res."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.1097\/QAD.0000000000003289","article-title":"Relationship between weight gain and insulin resistance in people living with HIV switching to integrase strand transfer inhibitors-based regimens","volume":"36","author":"Milic","year":"2022","journal-title":"AIDS"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"2380","DOI":"10.1093\/jac\/dkab158","article-title":"Switching from boosted PIs to dolutegravir decreases soluble CD14 and adiponectin in high cardiovascular risk people living with HIV","volume":"76","author":"Assoumou","year":"2021","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1097\/QAI.0000000000002447","article-title":"Metabolic Changes Associated with the Use of Integrase Strand Transfer Inhibitors Among Virally Controlled Women","volume":"85","author":"Summers","year":"2020","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"e474","DOI":"10.1016\/S2352-3018(22)00094-7","article-title":"Associations between integrase strand-transfer inhibitors and cardiovascular disease in people living with HIV: A multicentre prospective study from the RESPOND cohort consortium","volume":"9","author":"Neesgaard","year":"2022","journal-title":"Lancet HIV"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"e26123","DOI":"10.1002\/jia2.26123","article-title":"Incidence of cardiometabolic outcomes among people living with HIV-1 initiated on integrase strand transfer inhibitor versus non-integrase strand transfer inhibitor antiretroviral therapies: A retrospective analysis of insurance claims in the United States","volume":"26","author":"Rebeiro","year":"2023","journal-title":"J. Int. AIDS Soc."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.diabet.2019.02.008","article-title":"Diabetes and dyslipidaemia are associated with oxidative stress independently of inflammation in long-term antiretroviral-treated HIV-infected patients","volume":"45","author":"Bastard","year":"2019","journal-title":"Diabetes Metab."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1093\/cid\/ciy146","article-title":"Higher Risk of Abdominal Obesity, Elevated Low-Density Lipoprotein Cholesterol, and Hypertriglyceridemia, but not of Hypertension, in People Living with Human Immunodeficiency Virus (HIV): Results From the Copenhagen Comorbidity in HIV Infection Study","volume":"67","author":"Gelpi","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Arrive, E., Viard, J.P., Salanave, B., Dollfus, C., Matheron, S., Reliquet, V., Arezes, E., Nailler, L., Vigouroux, C., and Warszawski, J. (2018). Metabolic risk factors in young adults infected with HIV since childhood compared with the general population. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0206745"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1210\/clinem\/dgae369","article-title":"Single-Cell Analysis of Subcutaneous Fat Reveals Profibrotic Cells That Correlate with Visceral Adiposity in HIV","volume":"110","author":"Bailin","year":"2024","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_86","first-page":"cvaf056","article-title":"The role of epicardial adipose tissue remodelling in heart failure with preserved ejection fraction","volume":"16","author":"Eringa","year":"2025","journal-title":"Cardiovasc. Res."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1097\/QAD.0000000000003997","article-title":"Epicardial fat tissue and diastolic dysfunction in both men and women with HIV","volume":"38","author":"Han","year":"2024","journal-title":"AIDS"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.1097\/QAD.0000000000004003","article-title":"Response to \u201cEpicardial fat tissue and diastolic dysfunction in both men and women with HIV\u201d","volume":"38","author":"Goldberg","year":"2024","journal-title":"AIDS"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1676","DOI":"10.1093\/cid\/ciad419","article-title":"Pericoronary Adipose Tissue Density, Inflammation, and Subclinical Coronary Artery Disease Among People with HIV in the REPRIEVE Cohort","volume":"77","author":"Foldyna","year":"2023","journal-title":"Clin. Infect. Dis."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1093\/infdis\/jiae094","article-title":"Signals From Inflamed Perivascular Adipose Tissue Contribute to Small-Vessel Dysfunction in Women with Human Immunodeficiency Virus","volume":"230","author":"Wilcox","year":"2024","journal-title":"J. Infect. Dis."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"11","DOI":"10.33696\/AIDS.6.048","article-title":"Potential Advantages of a Well-balanced Nutrition Regimen for People Living with Human Immunodeficiency Virus Type-1","volume":"6","author":"Basta","year":"2024","journal-title":"J. AIDS HIV Treat."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1016\/j.clnu.2017.05.032","article-title":"Effects of docosahexanoic acid on metabolic and fat parameters in HIV-infected patients on cART: A randomized, double-blind, placebo-controlled study","volume":"37","author":"Domingo","year":"2018","journal-title":"Clin. Nutr."},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Pastor-Ib\u00e1\u00f1ez, R., Blanco-Heredia, J., Etcheverry, F., S\u00e1nchez-Palomino, S., D\u00edez-Fuertes, F., Casas, R., Navarrete-Mu\u00f1oz, M.\u00c1., Castro-Barquero, S., Lucero, C., and Fern\u00e1ndez, I. (2021). Adherence to a Supplemented Mediterranean Diet Drives Changes in the Gut Microbiota of HIV-1-Infected Individuals. Nutrients, 13.","DOI":"10.3390\/nu13041141"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1097\/QAD.0000000000003791","article-title":"Weight loss associated with semaglutide treatment among people with HIV","volume":"38","author":"Haidar","year":"2024","journal-title":"AIDS"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1097\/QAD.0000000000003816","article-title":"Is the GLP-1 receptor agonist, semaglutide, a good option for weight loss in persons with HIV?","volume":"38","author":"Lee","year":"2024","journal-title":"AIDS"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/S2213-8587(24)00150-5","article-title":"Once-weekly semaglutide in people with HIV-associated lipohypertrophy: A randomised, double-blind, placebo-controlled phase 2b single-centre clinical trial","volume":"12","author":"Eckard","year":"2024","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_97","first-page":"579","article-title":"Weighing in: Glucagon-like Peptide-1 Receptor Agonism for Persons with HIV","volume":"32","author":"Thomas","year":"2024","journal-title":"Top. Antivir. Med."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/14\/6546\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:06:15Z","timestamp":1760033175000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/14\/6546"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,8]]},"references-count":97,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["ijms26146546"],"URL":"https:\/\/doi.org\/10.3390\/ijms26146546","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,8]]}}}