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Author Notes:

Lauren F. Collins, MD. Division of Infectious Diseases, Emory University School of Medicine, 49 Jesse Hill Jr Drive, Atlanta, GA 30303. lauren.frances.collins@emory.edu

The authors declare no conflicts of interest relevant to this manuscript. Human and Animal Rights and Informed Consent This article does not contain any studies with human or animal subjects performed by any of the authors.


Research Funding:

The authors’ research activities are supported, in part, by grants from the National Institutes of Health/National Center for Advancing Translational Sciences (NCATS) (TL1TR002382, UL1TR002378).


  • Human immunodeficiency virus
  • age-associated comorbidities
  • antiretroviral therapy
  • chronic hepatitis C virus
  • direct-acting antivirals
  • metabolic syndrome

Metabolic Syndrome in HIV/HCV Co-infected Patients.


Journal Title:

Curr Treat Options Infect Dis


Volume 11, Number 4


, Pages 351-371

Type of Work:

Article | Post-print: After Peer Review


PURPOSE OF REVIEW: We review the scope and burden of metabolic syndrome in HIV/HCV co-infected patients, risk factors and potential mechanisms driving the increased cardio-metabolic risk in this population, and discuss relevant clinical considerations for management in the era of highly effective antiretroviral therapy (ART) and curative anti-HCV direct-acting antivirals. RECENT FINDINGS: HIV/HCV co-infected patients are at elevated risk of metabolic syndrome, attributed to (1) patient-specific factors, (2) viral-mediated effects, and (3) ART exposure. Risk factors for cardio-metabolic disorders are common in this population and include poor socioeconomic conditions, substance use, cardiovascular comorbidities, and liver/kidney disease. Chronic HIV/HCV infection induces an inflammatory and immune activated state in the host leading to alterations in glucose and lipid metabolism. Selection of life-saving ART must carefully consider the differential metabolic risk associated with each drug class and agent, such as dyslipidemia, hyperglycemia and insulin resistance, weight gain and hypertension. Emerging evidence supports metabolic derangements in chronic HCV may be improved by viral eradication with direct-acting antivirals, however, additional study in HIV/HCV co-infected patients is needed. SUMMARY: Future research programs should aim to better characterize metabolic syndrome in HIV/HCV co-infected patients with the goal of improved screening, treatment and prevention.

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