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High Cholesterol Levels
Aug 28, 2000

Since I've become HIV+, my Cholesterol levels went from 178 2.5 years ago to 290 where it is now. I'm beginning to worry. I've changed my eating habits drastically since becoming positive. I drink tons of water, my BIA analysis shows I have excellent levels of Body Fat, water in and out of cells, etc. I've been reading that HAART can cause higher levels of Cholesterol, I'm taking Combivir and Viramune. What can be done? 75% of what I eat is healthy fruit, vegetables, I hardly ever eat fried foods, I don't eat junk food like potatoe chips, I use butter spreads to improve my Cholesterol levels, yet it still is steadily climbing. Should I stop worrying about my HIV infection if I'm going to fall over someday soon from a heart attack?

Response from Dr. Cohen

Well -- a few comments... first -- it is great to see that Dan Quayle had a durable impact on society including its approach to spelling common snack food items...

As for your cholesterol. In someone who is a nonsmoker, with a normal blood pressure, exercising, with a reasonable family history without a high risk of early heart disease -- then the impact of just an elevated cholesterol is small. Very small in fact -- like it might add about a 1% risk to your having a heart attack in the next 5 years. Maybe 2%. Hard to say -- your HDL and LDL profiles would help somewhat. But this degree of elevation in just the cholesterol has a small impact on your future risk, if that is your only risk factor for heart disease. Now if you were a smoker, or had elevated blood pressure, or had a family history of early heart trouble then this cholesterol would have a greater impact -- these risk factors multiply each other in that case.

It is a bit surprising that your cholesterol is up this much as well. Your med combo is not expected to increase the cholesterol measures -- in fact we use med combos such as this one as a substitute for those who have elevations on other meds. But in any case -- we have meds that can lower the cholesterol pretty effectively. The usual choices include meds known as "statins", or fibrates (especially if you also have elevated triglycerides). There are other approaches -- such as high doses of niacin, that some might consider as well.

You never did say what was in that other 25% of what you were eating by the way -- even if 75% is healthy, and the other 25% is high in cholesterol or saturated fat, then it can have an impact...

But you can stop worrying about both your HIV and your heart -- just by treating both well.

Good luck.



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