Cholesterol and triglycerides

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February 2015

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 applicable, and antiretroviral treatment favor the appearance of these changes, which are coupled with those of age and which are related to the way 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 high total cholesterol result is obtained, another test will be required to check the levels of two types of cholesterol: HDL and LDL, although many physicians already request all exams at the outset.

HDL cholesterol is also known as 'good' cholesterol because it eliminates fat from the arteries. It is advisable to have a concentration above 40 mg / dL.

Already LDL cholesterol, 'bad', should remain at a concentration below 180 mg / dL. This molecule takes fats from the liver to other parts of the body, and in 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 available from the public health system in Spain.

Physical exercise endurance (running, swimming, cycling) can also be very positive.

A study of the effect of physical exercise and testosterone on the part of men with HIV has found that testosterone reduces HDL cholesterol levels, something undesirable 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.

Lipid-lowering drugs

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)

Original Issue:

Working Group on Treatment of HIV (TWG)
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Calle Sardenya, 259 3º 1ª
08013 Barcelona (Spain)

Translation into Portuguese in Brazil by:

Raquel Cirne
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Publishing and Editing:

Claudio Souza:


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