What can patients do?

General advice aimed at reducing lipid levels and reducing the chance of heart disease may be considered:

• Exercise regularly, stop smoking, and use alternative forms of birth control to the contraceptive pill (e.g. condoms, caps).
• Resistance and aerobic exercise may increase muscle and body mass.
• Discuss monitoring your triglycerides, cholesterol and blood glucose with your doctor. Sophisticated monitoring of the heart is not generally warranted unless other symptoms or tests suggest heart problems.
• Ask your doctor about monitoring for fat wasting and lipodystrophy.
• Changes to diet, such as reducing fat and sugar intake, may reduce a person's chance of diabetes, elevated blood lipids and heart disease. Of course, dietary changes may be difficult given that all protease inhibitors except indinavir are taken with a high-fat meal. Consult an HIV dietitian to ensure you don't inadvertently lose weight.
• Aspirin (acetylsalicylic acid) can prevent blood clotting, and is used to reduce the risk of heart attack and stroke in some HV-negative patients. Aspirin has not been studied as a preventive measure in HIV-positive patients, although some recommend its use.¹
• Mild blood fat elevations plus low HDL cholesterol may not respond to a low-fat diet. Ask your dietitian about mono-unsaturated fats.