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Ask the Experts about Lipodystrophy and Wasting

 

high level of blood fat
Apr 20, 2000

Dear Dr,

I'm infected for 19 months. And since June of 1999, my blood fat keep rising. I never take any medicine against HIV. Do you think HIV can cause the high level of blood fat?

Can any common medicine (such as L-CARNITINE) make the blood fat lower?

Thanks!

Response from Dr. Hellerstein

Great question, and very important to your health!

It turns out that high levels of blood fats (usually the type called triglycerides) are very common in people with HIV infection. This occurs without antiviral therapy, and can get worse with some types of antivirals. The changes in blood fats can predispose HIV-infected persons to heart disease and other complications, most providers believe.

What can you do about this? There are a number of medications that can bring down the levels of blood fats, with a greater or lesser degree of effectiveness. These include gemfibrozil (Lopid), atorvastatin (Lipitor), metformin (Glucophage) and niacin (many brand names). Diet is also very important. It is best to talk to a dietician, to work out the best diet for this.

Carnitine is probably not very potent toward this goal, although proper studies have not been performed in patients with HIV infection. It probably would not cause any harm to use carnitine, but don't expect it to fix the problem.

Finally, treatment against the virus is always the first step in any health maintenance plan (as I'm sure you've heard before).

This is an important observation that you have become aware of about your health status. I'd strongly encourage you to pursue it and try to get your blood fats under control.

Good luck!

Marc Hellerstein, M.D., Ph.D.



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