I am a 35 year old female who tested HIV+ in 1990, right now my viral load is <50 and my T-Cells are 652. During the past few years my Triglicerides have been steadily rising, last month they went to 3457 and my cholesterol is now at 585. I tried Lipator with no luck. I have been taking Niacin for approx. 6 months now with a dose of 500 mg. after each meal. Nothing seems to be working. I am taking Norvir, Fortavase, Zerit, and DDI. I have also started wasting, I've lost approx. 10% of my LBM. I watch my diet and exerciese a few days a week. What are your thoughts and suggestions? I don't know what to do.

I would appreciate any information you could give me.

Thanks

Susan

Dear Susan,

The likely cause of your cholesterol and TG elevation is the Norvir. This is part of the lipodystrophy syndrome. You should certainly consider treating the cholesterol and TG's more aggressively with things like gemfibrozil plus lipitor. On the other hand, you could try switching to a protease-sparing regimen of meds for a while. In the meantime, would also consider checking your testosterone and perhaps adding megestrol to your regimen to help the fat maldistribution. Douglas T. Dieterich, M.D.