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Apr 13, 2010

Im worried because my boyfriend is HIV positive, going through treatment, but the triglycerids are over 700. The doctor said he neede to follow a special diet and exercise. I heard of Clint Waters, who was 31, that was going through treatment and recently died of heart attack, he was thin and exercised a lot, is the risk too high? diet and exercise are enough? thanks

Response from Dr. Frascino


For HIVers who have triglycerides over 700, I do not feel diet and exercise are enough, although a healthy diet and a regular exercise program are certainly part of the management and recommended for everyone despite HIV status or triglyceride level.

In addition I would:

1. Review the rest of the lipid profile (cholesterol, etc.). If there is evidence of lipid abnormalities, I would review the current antiretroviral therapy to see if a change to a more lipid-friendly regimen was an option.

2. I would treat with a triglyceride-lowering agent (Gemfibrozil) and fish oil to lower triglyceride levels. High triglycerides not only can contribute to cardiac problems, but they can also cause pancreatitis. Your boyfriend should talk to his HIV specialist again about this problem. If the physician is still reluctant to treat, I would advise you get a second opinion from a more competent HIV specialist.

Good luck.

Dr. Bob

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