ABSTRACT Chronic HIV-1 infection is associated with immune activation and inflammation due at least in part to persistent low levels of circulating pro-inflammatory mediators such as lipopolysaccharide, IL-6, and TNF-α. These mediators can modulate cellular metabolism. Thus cells of the immune system must constantly modify their metabolic phenotype according to their changing functional requirements and their environment. During a viral infection, immune cells increase their nutrient uptake and metabolic activity to mount an antiviral response. Changes in glucose and lipid mobilization and metabolism have emerged as being central to this metabolic response. The chronic exposure of leucocytes to an inflammatory milieu may impose an aberrant nutrient metabolic profile in these cells and lead to reduced cell function. Additionally, both HIV-1 infection and antiretroviral therapy induce changes in systemic levels of adipokines and classical inflammatory cytokines released by adipose tissue that may induce endocrine effects on nutrient uptake and metabolism by leucocytes.
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