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What can I do about my cholestorol
Aug 18, 2007


I am on sustiva/truvada and I recently got the following cholesterol report:

HDL: 41 LDL: 112 Trigliceryides: 325 Total: 218

What can I do to improve these numbers? Does this medication combination tend to affect cholesterol?

Response from Dr. Young

Thank you for your post.

The concern about cholesterol and triglycerides relates to how these factors increase your risk of cardiovascular disease. As such, it would be remiss not to address other cardiovascular risk factors while talking about your lipids. These include diet, exercise, high blood pressure, diabetes and most importantly, smoking.

We'll assume that your labs were drawn while fasting. (If not, then they should be repeated). Your labs indicate a mild-moderate elevation in your total cholesterol and a moderate elevation in the triglycerides. Both of these factors respond somewhat to diet and exercise changes- in my view, these are the first things to try before talking about medication additions.

Should diet and exercise not result in desired improvements, then there are several medications that are used in this setting. Since your cholesterol and triglycerides are elevated, then a "statin" drug, like pravachol is often used.

The regimen that you're taking has only limited effects on lipids, but can cause mild elevations- almost certainly due to the efavirenz (Sustiva) rather than tenofovir+FTC (Truvada) parts. I would expect modest improvements only with a switch from efavirenz, particularly if the switch is to a protease inhibitor.

Hope this helps, BY

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