The epidemiological profile of people living with HIV (PLWH) has expressively changed since the introduction of antiretroviral therapy (ART), from a high mortality rate to a profile similar to those living with chronic diseases. Despite the advances and effectiveness of ART, there are still various challenges to overcome, and we highlight the increased risk of sarcopenia in PLWH. This review study aims to (i) explore the pathophysiological background of sarcopenia in PLWH under the different existing ART and (ii) develop a mini-systematic review searching epidemiological studies investigating sarcopenia prevalence in PLWH. As our main findings: we established the risk of sarcopenia development, under a sequential path involving HIV, ART, immune activation, low-grade systemic inflammation, metabolic disorders, and changes in protein synthesis and breakdown in skeletal muscle tissue; some ART drugs, mainly reverse transcriptase inhibitors and protease inhibitors, contribute to critical metabolic changes, lowering the autophagy, increasing mitochondrial dysfunction and insulin resistance, which favor the development of inflammation and muscle protein breakdown. There is still insufficient data to discuss the effects of the new generation drugs, namely integrase inhibitors and fusion inhibitors, on skeletal muscle. More studies are needed to better clarify these relationships.

中文翻译：

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接受抗逆转录病毒治疗的 HIV 感染者的肌肉减少症：文献综述。

自引入抗逆转录病毒疗法 (ART) 以来，艾滋病病毒感染者 (PLWH) 的流行病学特征发生了显着变化，从高死亡率变为与慢性病患者相似的特征。尽管 ART 取得了进步和有效性，但仍有各种挑战需要克服，我们强调 PLWH 患肌肉减少症的风险增加。本综述研究旨在 (i) 探索不同现有 ART 下 PLWH 肌肉减少症的病理生理学背景，以及 (ii) 开展一项小型系统综述，检索调查 PLWH 肌肉减少症患病率的流行病学研究。作为我们的主要发现：我们在涉及 HIV、ART、免疫激活、低度全身炎症、代谢紊乱、骨骼肌组织中蛋白质合成和分解的变化；一些 ART 药物，主要是逆转录酶抑制剂和蛋白酶抑制剂，有助于关键的代谢变化，降低自噬，增加线粒体功能障碍和胰岛素抵抗，这有利于炎症和肌肉蛋白分解的发展。仍然没有足够的数据来讨论新一代药物，即整合酶抑制剂和融合抑制剂，对骨骼肌的影响。需要更多的研究来更好地阐明这些关系。这有利于炎症和肌肉蛋白质分解的发展。仍然没有足够的数据来讨论新一代药物，即整合酶抑制剂和融合抑制剂，对骨骼肌的影响。需要更多的研究来更好地阐明这些关系。这有利于炎症和肌肉蛋白质分解的发展。仍然没有足够的数据来讨论新一代药物，即整合酶抑制剂和融合抑制剂，对骨骼肌的影响。需要更多的研究来更好地阐明这些关系。