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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Side effects of Lopinavir/Ritonavir
Jul 19, 2013

Dear Dr Henry I am a practising HIV clinician in South Africa and am unsure as to how to attribute dyslipidaemia to solely the use of Lopinavir/Ritonavir or other causes. Is there a time frame when this drug can be excluded as a causative agent? How should I be monitoring lipids in patients on Lopinavir/Ritonavir? Our national guidelines merely tell us to perform ONE lipid profile after 3 months of use. Please assist me in making the best, most cost effective decision. Thank you.

Response from Dr. Henry

The effect of lopinavir/ritonavir is usually most profound on the triglycerides followed by cholesterol levels. Knowing the baseline lipid levels before starting a regimen and then the levels 1-3 months after starting usually is sufficient. If only 1 level allowed then the 3 month time period (recommend fasting if possible to best utilize the information)seems very reasonable. The cardiovascular risk for increased lipids need to be assessed in relation to overall risk (ie smoking, baseline lipid levels, exercise, family history et cetera). KH

Switching from EFV (sustiva) to NVP
Using Arava while HIV-positive, low CD4 count

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