Antiretroviral therapies (ARTs) benefit millions with human immunodeficiency virus. However, concerns about subsequent weight gain and related metabolic complications have emerged. Early ARTs are associated with adipose tissue changes. While newer ARTs may have fewer adipose alterations, it is unclear whether they lead to increased weight gain. A systematic literature review was performed to describe current published literature describing the use of newer ARTs, weight gain, and related comorbidities. Titles and abstracts were screened, focusing on studies that examined ART initiation and subsequent weight gain; publications were then ranked based on publication type, methodology, and comorbidities, emphasizing US studies with large patient cohorts. This yielded a comprehensive review of the 50 publications on weight gain and a range of related comorbidities, including diabetes and hypertension. Most of the studies describing weight gain found the most significant gains during the first year after initiating ART. Overall, patients gained ∼5 kg 18–96 months after initiating ART. Many of the studies reported altered weight-related comorbidities, including increased risk of diabetes and hypertension. Despite an expectation that newer ARTs may be safer, a review of the literature suggests that contemporary ART use is associated with pronounced weight gain and related comorbidities. Future studies should define and quantify the direct role of newer ARTs in weight gain and related comorbidities, as well as clarify the role of specific drug classes in metabolic disturbance, to improve intervention strategies.

中文翻译：

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2000 年代开始抗逆转录病毒治疗后体重增加和相关合并症：系统文献综述

抗逆转录病毒疗法 (ART) 使数百万人因人类免疫缺陷病毒受益。然而，出现了对随后体重增加和相关代谢并发症的担忧。早期 ART 与脂肪组织变化有关。虽然较新的 ART 可能有较少的脂肪改变，但尚不清楚它们是否会导致体重增加。进行了系统的文献综述以描述当前已发表的文献，这些文献描述了使用较新的 ART、体重增加和相关合并症。对标题和摘要进行筛选，重点是检查 ART 开始和随后体重增加的研究；然后根据出版物类型、方法和合并症对出版物进行排名，强调美国对大型患者队列的研究。这对 50 篇关于体重增加和一系列相关合并症（包括糖尿病和高血压）的出版物进行了全面审查。大多数描述体重增加的研究发现，在开始抗逆转录病毒疗法后的第一年，体重增加最为显着。总体而言，患者在开始 ART 后 18-96 个月体重增加了约 5 kg。许多研究报告称体重相关的合并症发生了改变，包括糖尿病和高血压的风险增加。尽管人们期望较新的 ART 可能更安全，但对文献的回顾表明，当代 ART 的使用与显着的体重增加和相关的合并症有关。未来的研究应该定义和量化新的 ART 在体重增加和相关合并症中的直接作用，并阐明特定药物类别在代谢紊乱中的作用，