There are two types of fat - or lipids - necessary for the proper functioning of our body, but its excess or deficiency can lead to unwanted complications.
In people with HIV infection itself, co-infection with hepatitis C, if appropriate, and antiretroviral therapy favor the appearance of these changes, which together with the own age and are related to the manner in which our body processes fats and sugars.
It is important that cholesterol and triglycerides are measured before initiating antiretroviral treatment and subsequently at regular intervals. For the results of these tests are reliable, it is necessary to respond to fasting blood test.
If a result of high total cholesterol is obtained, another test is requested to establish the levels of two kinds of cholesterol: HDL and LDL, although many physicians have to request all examinations at the start.
Ocolesterol HDL is also known as 'good' cholesterol because it removes the fat from the arteries. It should therefore be a concentration above 40 mg / dL.
Already LDL cholesterol, "bad", must remain in a concentration below 180 mg / dL. This molecule carries fats liver to other parts of the body, and excess can contribute to the development of cardiovascular diseases.
Diet and exercise
You can improve cholesterol levels and reducing triglyceride of saturated fats and cholesterol in their diet, as well as alcohol and tobacco.
Consumption of foods rich in omega-3 (such as blue fish) or supplements of these fatty acids can lower triglyceride levels. Omacor®is the trade name of omega-3 provided by the public health system in Spain.
Physical exercise endurance (running, swimming, cycling) can also be very positive.
A study on the effect of exercise and testosterone attended by men with HIV noted that testosterone reduces HDL cholesterol levels, something not desirable for people with lipodystrophy who already have high levels of triglycerides and LDL cholesterol.
The medicated group with testosterone obtained a greater increase in muscle and a greater weight loss, but HDL levels increased in the group that practiced exercise without testosterone, which seems more appropriate for people with HIV and lipodystrophy.
Anabolic steroids, synthetic derivatives of testosterone, they can increase muscle mass but also reduce fat, which may worsen lipoatrophy and lipid levels.
If food, supplements and exercise are not enough, your doctor may choose to modify their antiretroviral treatment or prescribe medications to lower LDL cholesterol or triglycerides. Generally, fibrates are used to treat high triglycerides and statins for lowering LDL cholesterol.
Some statins interact with certain antiretrovirals and may be contraindicated or need dose adjustments. The most used by people with HIV who take antiretroviral medication are fluvastatin, pravastatin and rosuvastatin.
Impact of antiretrovirals
The antiretroviral combinations may be more or less related to these metabolic complications, according to the type and the drug in concrete. The following table is very useful to get a general idea of the impact of the drugs separately.
Insulin Resistance Index More on Lipodystrophy (Site Know Living)
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