Changes in blood fats (lipids)

Several large studies have shown changes in lipid metabolism in people with HIV even before treatment starts - in particular, a decline in HDL cholesterol that may not be reversed by antiretroviral therapy. Modest lipid changes after starting treatment may then simply represent a return toward normal metabolism; there is controversy over the extent to which this is true. A study of 50 seroconverters in the MACS cohort has shown that lipid increases after commencing HAART represent a return to normal levels for the age group when participants were matched with a cohort of HIV-negative individuals. Cholesterol levels were depressed and triglyceride levels elevated after seroconversion. 1

Some findings have suggested that since HIV itself uses cholesterol for new virion assembly and budding, it has evolved a way to regulate human cholesterol metabolism. One study has found that a protein (nef) in HIV causes macrophages to accumulate more cholesterol, and to develop more rapidly into the plaques that contribute to narrowing of the arteries. 2 3 However, this does not fully explain the lipid changes seen in the course of HIV infection and treatment.


  1. Riddler S et al. Serum lipids and antiretroviral therapy among HIV-infected men. Tenth Conference on Retroviruses and Opportunistic Infections, Boston, abstract 750, 2003
  2. Muajawar Z et al. Human immunodeficiency virus impairs reverse cholesterol transport from macrophages. PLoS Medicine 4(11):e365, 2006
  3. Carr A and Ory D Does HIV cause cardiovascular disease? PLoS Medicine 3(11):e496, 2006
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.