Management of dyslipidemia in patients with HIV disease

Abstract

The epidemiological, etiopathogenetic, laboratory and clinical features of serum lipid abnormalities occuring in the course of HIV disease are still poorly understood (especially when the supporting role of single antiretroviral compounds is considered), while limited literature data are to date available regarding the management of HIV-related dyslipidemia, as well as the efficacy and safety of dietary-exercise programs, and that of selected hypolipidemic agents. At this time, a careful monitoring of serum lipid profile is needed during combination antiretroviral therapy including protease inhibitors, in order to suggest a diet and hypolipidemic treatment when applicable, and to prevent clinical sequelae related to long-term dyslipidemia. The selection of an appropriate hypolipidemic agent is difficult, since no controlled studies are available in this field, and possibly increased risks of pharmacologic interactions, toxicity and impaired patient's adherence should be taken into consideration. Waiting for specific guidelines for the treatment of hypertriglyceridemia and hypercholesterolemia in the setting of HIV infection, all available literature reports dealing with the management of HIV-associated hyperlipidemia are briefly discussed, on the basis of personal clinical experience.