Hyperlipidemia and HIV/AIDS: High Cholesterol and Triglycerides

Drugs for Hyperlipidemia

Sometimes, despite diet and exercise, lipids cannot be kept at healthy levels without the help of drugs. There are a variety of drugs available to help lower cholesterol and triglycerides. Some of these may interact with HIV drugs. To reduce the chance of drug interactions, make sure your health care provider is aware of all the medications you take.

If you take a lipid-lowering drug, it is still important to include a good diet and exercise in your lifestyle to help the drug work its best. It is also important to take the drug consistently.

HIV Drugs and Hyperlipidemia

Some HIV drugs have been:

• Found to cause changes in lipid levels
• Tied to diabetes -- another risk factor for heart disease
• Linked to an increased risk of heart attacks, for reasons that are not clearly understood

While experts agree that heart disease risks are associated with some HIV medications, there are also important benefits to the heart and immune system from HIV treatment. It is important to work with your health care provider to weigh the risks and benefits of the HIV medications you choose.

There are some HIV drugs that have less of an impact on cholesterol and triglycerides. These include Edurant (rilpivirine), Viramune (nevirapine), Intelence (etravirine), Isentress (raltegravir), and Selzentry (maraviroc). Reyataz (atazanavir) and Prezista (darunavir) are also less likely to increase lipids, but both require use with Norvir (ritonavir), and Norvir does increase lipids.

If you take HIV drugs, be aware of the possible side effects. Get monitored at regular medical check ups for high lipid levels. Do not stop or make changes to your HIV drug regimen without speaking to your health care provider.

Other Risks for Heart Disease

Other factors that increase a person's risk of heart disease include:

• Family history of heart disease
• Little or no physical activity
• High fat, high sugar diet
• High blood pressure
• Age (women over 55, men over 45)
• Obesity
• Diabetes
• Smoking

Try these tips for lowering cholesterol and triglycerides and decreasing other risk factors:

• Avoid fried foods
• Avoid adding extra fats like butter, sour cream, dressings, and gravies to foods
• Limit sweets and snack foods
• Cut excess fat and skin off meats
• Choose skim or one percent milk instead of whole or two percent milk
• Limit cheese or try low fat cheeses
• Choose whole grain breads instead of white breads; choose brown rice instead of white rice
• Increase fiber with whole grains, fruits and vegetables, and cooked beans
• Eat fish three times a week
• Increase aerobic exercise to three or four times a week for 30 minutes or more
• If your health care provider has prescribed lipid-lowering drugs, make sure to take them consistently
• Try to lose weight if you are overweight
• If you smoke, try to quit or at least cut down

Taking Care of Yourself

If you have hyperlipidemia, it is especially important to take care of your body. Keep all of your medical appointments, get regular lab tests, and tell your health care provider about any changes in the way you feel or in your body shape.

Hyperlipidemia and other conditions associated with lipodystrophy have been linked with heart disease and strokes in HIV+ people, so make sure you are monitored closely. Other factors also contribute to the risk of heart attacks and strokes, including high blood pressure. If you have high blood pressure, make sure it is treated. You can also support your body, and especially your heart, with a healthy diet, regular exercise, and limiting or stopping tobacco use.