Lipid Disorders in People with HIV

Review
In: Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000.
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Excerpt

Dyslipidemia is highly prevalent in people with HIV (PWH) and contributes to the increased risk of cardiovascular disease seen in this patient population. Factors that contribute to dyslipidemia include HIV infection itself and certain types of antiretroviral therapy (ART). Moreover, the effects of ART on lipids have changed over time as newer therapies have become available. Because some ART medications interact with lipid-lowering therapies, the type of lipid-lowering therapy initiated needs to be considered in this context. Of note, current cardiovascular disease (CVD) risk calculators underestimate CVD risk in PWH because HIV-specific factors also contribute to CVD. HIV-specific variables should be taken into account when calculating atherosclerotic CVD risk in PWH. In addition to statins, other lipid lowering agents, including PCSK9 inhibitors, have been studied in PWH and can be considered in the treatment of dyslipidemia, particularly for low-density lipoprotein (LDL-C) lowering. The ongoing REPRIEVE study will contribute to a better understanding of the use of statins in primary prevention of CV disease in PWH with low CVD risk. Aggressive lipid management in PWH is essential for primary and secondary CVD prevention and optimization of health span and lifespan in this high-risk population. For complete coverage of all related areas of Endocrinology, please visit our on-line FREE web-text, WWW.ENDOTEXT.ORG.

Publication types

  • Review