Metabolic Complications of HIV and Antiretroviral Therapy: Dyslipidemia, Insulin Resistance, and Cardiovascular Disease

  • Authors: Judith S. Currier, MD, MSc; Risa Hoffman, MD, MPH (More Info)
  • Editors in Chief: Joseph J. Eron, Jr., MD; Daniel R. Kuritzkes, MD
  • Last Reviewed: 10/10/18 (What's New)


    Screening for Dyslipidemia
    • Baseline fasting lipids should be recorded for all HIV-infected patients at entry into care
    • If no lipid abnormalities are present, repeat screening should be performed every 6-12 months, or more frequently if risk factors such as obesity, diabetes, fat redistribution, or a family history of dyslipidemia are present
    Strategic Management of Dyslipidemia
    • ACC/AHA guidelines on management of blood cholesterol recommend moderate- or high-intensity statin therapy in 4 target populations (Table 3) (Management Guidelines)[ACC/AHA 2013]
      Metabolic Syndrome in HIV: Definition, Prevalence, Management
        Treatment and Monitoring of Dyslipidemia
          Role and Limitations of Lifestyle Modifications
            Treatment of Dyslipidemia With Statins
            Treatment of Dyslipidemia With Other Therapeutic Options
                Other Agents
                  Monitoring Patients Receiving Lipid-Lowering Therapy
                  Treatment of Dyslipidemia by Modifying Antiretroviral Therapy
                    Switching NRTIs
                      Switching to an NNRTI
                        Switching to an Integrase or CCR5 Inhibitor
                          Primary Prevention of Dyslipidemia
                            Considerations for Resource-Limited Settings

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