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HDL - How worried should I be?
Sep 19, 2004

I have been positive for 8 years. About 4 months ago I went in for my routine labs and was told that my Cholesterol was abnormal; specifically the HDL. Everything else was WNL. My HDL tested at 29. I was started on Pravachol. I have since been retested with HDL now at 17. How concerned should I be about this? Is there any options other than Pravachol? I am on meds: Ritonavir, Atazanavir,Tenofovir, Didanosine. Any help would be greatly appreciated.

Response from Dr. Holodniy

Although elevated LDL cholesterol is thought to be a significant risk factor for increased cardiac disease, a decreased HDL (<35-40) also increases the risk as well. You don't indicate what your total cholesterol and LDL were before starting pravachol. You also don't indicate what your viral load results are currently. Ritonavir may be contributing to the problems with cholesterol. If your viral load is undetectable with this regimen, stopping the ritonavir and continuing everything else might help the lipid situation. Otherwise you are stuck with trying to increase the HDL by trying certain modalities such as stopping smoking, an exercise program, losing weight if overweight, some alchohol consumption and increased soluble fiber in the diet among other things.



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