Many adults, as they get older, tend to experience an increase in their lipids (hyperlipidemia). “Lipids” is the general term for fats in the bloodstream, most notably cholesterol and triglycerides. Many HIV-positive people are also experiencing increases in their blood lipids. While this shouldn't come as a surprise, given that HIV-positive people are now living longer, it's also clear that many HIV-positive people are experiencing profound increases in their cholesterol and triglyceride levels as a result of the anti-HIV medications they are taking.
This has raised fears that HIV-positive people taking these medications are at a higher risk of experiencing a heart attack or a stroke as a result of their hyperlipidemia. But we're also learning how best to manage these increased lipid levels, through delaying anti-HIV treatment until it's absolutely necessary, selecting anti-HIV drugs carefully, switching treatments when problems arise, initiating dietary changes and exercise programs, and prescribing lipid-lowering drugs to help bring cholesterol and triglyceride levels under control.
This lesson reviews what we know – and what we don't know – about increased lipids in HIV-positive people. The first part of this lesson reviews the basics of elevated lipids, including the medical terms that are important to know. The second part of this lesson reviews the causes of increased lipid levels, including the various anti-HIV drugs that have been shown to play a role. The third part reviews what we know about managing increased lipids, including switching anti-HIV drugs and using other treatments to reduce lipids and to reduce the risk of a heart attack or stroke.
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