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High Triglycerides & HIV
May 12, 1997
Dr. Gallant: I have a question on high triglycerides related to HIV.
Brief history, current CD4 count 800, viral load
undetectable. Current meds., Crixivan, AZT, Zerit, 3tc. Two months ago
trigylcerides were 9700, and I developed acute
pancreatitis. I am now recovered and on lopid for the high
triglycerides, 3 times a day. Recent triglycerides were 933 and a
very low fat diet, 20 grams per day. Are high triglycerides caused by
the virus, medications or what? Any suggestions to
lower the triglycerides so I don't develope pancreatititis again. Thanks
for your great information.
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Response from Dr. Gallant
Although it's possible that your high triglycerides are unrelated to HIV
or your medications, the most common reason for high triglycerides in
HIV-infected people is therapy with protease inhibitors (Crixivan in
your case).
Most of the time the high triglycerides don't do any damage, but when
they become very high they can lead to trouble (like pancreatitis).
Gemfibrozol (Lopid) is the drug most commonly used to treat this
condition. It sounds like you are doing everything you can do to treat
this, short of stopping your Crixivan.
One more thing--d4T (Zerit) can also cause pancreatitis, though it's not
common. Also, there's evidence that taking AZT and d4T together may be
a bad idea. The two drugs appear to compete with each other in the
cell, and in one study people taking AZT + d4T did WORSE than people
taking d4T alone. For that reason, it's now recommended that the two
not be combined.
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