Metabolic complications of HIV infection: translating research findings into clinical practice.

The editors of ACC recognize that our coverage of the topic of metabolic complications is unable to address all of the issues that clinicians face on a daily basis. The absence of information to guide clinicians on the management of lipoatrophy, fat accumulation, avascular necrosis, and breast enlargement is a reflection of the limitations of current data, not a statement about the importance of these topics. As new data emerge in these areas we will strive to keep our readers informed. Much work remains to be done in defining the causes of, and treatments for, the metabolic complications of HIV infection. For starters, a more critical assessment of the metabolic profiles of each of the available antiretroviral agents--or, at a minimum, an understanding of their impact on lipid levels and glucose metabolism in treatment-naive patients--is long overdue. Although it is clearly not possible to examine all of the potential combinations of the available agents in equal depth, some basic information about all of the FDA-approved drugs should be developed. Only through careful study of the underlying mechanisms by which these agents contribute to the development of the myriad of metabolic abnormalities will we be able to develop new agents and optimal management strategies for people living with HIV infection.