Adiponectin Secretion in HIV-Infected Subjects with or without Antiretroviral Treatment and Illicit Substance Use: Clinical Review and Update

Abstract

Adiponectin (Acrp30) is a novel polypeptide classified among adipokines that are chiefly secreted by adipocytes within adipose tissue. Besides the adipose tissue, levels of the adipocytokine also circulate in human plasma. Functionally, Acrp30 possesses a primary role in regulation of body fat stores with its anti-inflammatory, glucose and lipid metabolism and weight loss effects. Thus, circulating Acrp30 levels govern obesity and metabolic abnormalities including; dyslipidaemia, cardiovascular disorders and renal disease. A lipodystrophic syndrome including metabolic derangements are common features presenting in HIV-infected patients on antiretroviral therapy (ART). Decreased Acrp30 levels have been documented in lipodystrophic patients as a consequence of adverse effects attributable to various antiretroviral agents. Interestingly, Acrp30 levels are revealed to be suppressed in HIV-infected patients relative to healthy persons even prior to HAART commencement, indicative of HIV infection itself playing a role in Acrp30 dysregulation. On the contrary, circulating Acrp30 levels inversely correlate with body fat composition in healthy non-obese individuals. Thus, lowered Acrp30 concentrations are associated with weight accumulation in obese subjects. More importantly, illicit drug and substance use has been revealed to accelerate HIV disease progression while also impairing Acrp30 production within the adipose tissue. Consequently, these observations collectively portray Acrp30 as a metabolic correlate of adipose tissue inflammation and low fat store during episodes of HIV infection, lypodystrophyic syndrome and illicit substance use. Therapeutic interventions should identify new approaches to restore Acrp30 production and supply during the aforementioned events.