Dr. Conway,

Hello I have been on a combo containing several protease inhibitors for a good five years. My lipids are shooting through the roof. I was advised to ask a specialist for a drug that works to lower lipids? Which is your drug of choice, lipitor? Or something else?

Nelson

You would have two options.

First, if you are responding to the current regimen with an undetectable viral load, you may consider a single drug switch of the protease inhibitor to a non-nucleoside drug (nevirapine or perhaps efavirenz). A number of studies have shown this to be a safe thing to do with respect to maintaining virologic suppression and may improve your lipid profile without you having to do anything else.

If you want or need to stay on the protease inhibitor, you should look to see if improving your diet, losing weight or doing more exercise are options for you to lower your lipid levels without resorting to drugs. If you need specific treatment, agents such as Lipidil are more directed at the triglyceride levels, while Lipitor is a good initial choice to lower the cholesterol.