A heart disease focus group set up by the US AIDS Clinical Trials Group (ACTG) has released preliminary guidance on the management of abnormal blood lipid levels in people taking antiretroviral therapy. A complete version of their recommendations is in press with Clinical Infectious Diseases and will appear in the summer.
The statement notes that whilst the association between HIV treatment and lipid abnormalities has been established for some time, whether this equates with a significant risk of heart disease remains unclear. Nevertheless, the focus group recommends that dysregulated lipids in people with HIV should be managed according to existing (US) advice for the care of the general population, namely the National Cholesterol Education Program guidelines. (Note that advice outside the US may differ).
However, the potential for negative drug interactions between standard lipid-lowering agents and antiretroviral drugs raises specific concerns for people with HIV. The use of non-drug therapies, e.g. dietary modifications, exercise, is therefore emphasised as a potentially more appropriate choice in many cases, particularly where the risk of heart disease is low, (such as in people who have no family history of heart disease, or no other risk factors).
For further information on these issues see coverage in Body fat and metabolic changes whilst on treatment here on aidsmap.com.