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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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High Lipids
Apr 24, 2002

Hello: I have a frustrating situation. I am currently on agenerase, ziagen, ddi and norvir. My viral load is undetectable and my t-cell count is 220. I have been HIV positive for 11 years. Here is my problem---while my VL and t-cells seem to be stable, my cholesterol is over 800 and my triglyerides and in the 1000 range. I haven tried lipitor and pravachol, but it doesn't even put a dent in those numbers. When I went off all meds about 3 months agao, my cholesterol returned to normal, but my t-cells went down to 75 and my VL went to 30,000. I had a phenotype test and I'm resistant to ddc, viracept, 3tc, viramune and sustiva. My doctor is pretty convinced the PIs are the problem...can I safely take just the DDI and ziagen and still keep my numbers? Although my HIV seems to be in contro, I don't want to drop dead of a stroke or heart attack at 36! Thanks!

Response from Dr. Henry

I would not be comfortable with just ddI and ziagen to control your HIV. You probably need a Protease Inhibitor. Much of your cholesterol likely is triglyceride rich fragments. Fenofibrate and niacin as well as careful diet intervention may be helpful (I would recommend a low-strength aspirin). If you can hold on for a while atazanavir will likely approved later this year and it has little effect on lipid levels (atazanvir and saquinavir can be combined as a once a day regimen with minimal effect on lipid levels). KH

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