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The term “metabolic health” has been recently introduced in the context of human immunodeficiency virus (HIV) to create a positive framework which considers metabolic variables that share complex pathophysiologic mechanisms, offering a new approach through a patient-centered care model [1]. Through pharmacologic and lifestyle interventions, this framework aims to improve wellness and health-related quality of life. Metabolic health is a roadmap that can guide individuals through their life and across the natural history of chronic diseases. This approach is particularly relevant because it considers the relationship between chronic viral infection, antiretroviral therapy (ART) exposure, the patient, and their environment. Both historically and at an individual patient level, metabolic health addresses anthropometric and metabolic changes at the fundamental turning points of the disease including ART initiation, ART switching, and aging with HIV. In this context, studies on weight gain (WG) demonstrate that body composition changes are at the intersection of many metabolic pathways in people with HIV (PWH).

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