Lipids and protease inhibitors

Several key studies have found that people taking protease inhibitors were at greater risk of elevated triglycerides and LDL cholesterol.1 2 3 4 High lipids occurred in 74% of the protease inhibitor recipients in one study.1

Some studies have found little difference between the different protease inhibitors in terms of the severity of lipodystrophy and metabolic disturbances, although the more recently developed PIs have been less studied. Ritonavir has been associated with a greater risk of high triglycerides than the other protease inhibitors;1 5 even low dose ritonavir, used to boost concentrations of other PIs, has been associated with elevated triglycerides.6 Atazanavir has been shown to have significantly less detrimental impact on lipids in treatment-naive individuals. See Atazanavir in A to Z of antiretroviral drugs for further details.

References

  1. Carr A et al. Diagnosis, prediction, and natural course of HIV-1 protease-inhibitor-associated lipodystrophy, hyperlipidaemia, and diabetes mellitus: a cohort study. Lancet 353: 2093-2099, 1999
  2. Mulligan K et al. Hyperlipidemia and insulin resistance are induced by protease inhibitors independent of changes in body composition in patients with HIV infection. Journal of Acquired Immune Deficiency Syndromes 23(1): 35-43, 2000
  3. Roth VR et al. Development of cervical fat pads following therapy with human immunodeficiency virus type 1 protease inhibitors. Clinical Infectious Diseases 27(1): 65-67, 1998
  4. Tsiodras S et al. Effects of protease inhibitors on hyperglycemia, hyperlipidemia, and lipodystrophy: a 5-year cohort study. Arch Intern Med 160:2050-2056, 2000
  5. Periard D et al. Atherogenic dyslipidemia in HIV-infected individuals treated with protease inhibitors. Circulation 100(7): 700-705, 1999
  6. McComsey GA et al. Effect of ritonavir-boosted protease inhibitor regimens on lipid profiles. 14th International AIDS Conference, Barcelona, abstract ThPeB7319, 2002b
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
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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.