Dyslipidemia: Antiretroviral Switching Strategies

Dyslipidemia: Summary and Conclusions

•	Dyslipidemia is frequent and only partly explained by impact of HAART
•	Initial management approach should be lifestyle modification (diet, exercise)
•	Lipid-lowering agents can be added as necessary, but beware of drug-drug interactions and toxicities
•	Switching to non-PI regimens is generally effective, but long-term efficacy is unclear
•	Cardiovascular sequelae are minimal short-term; long-term outcome is unknown
• Dyslipidemia is a frequent syndrome in patients with HIV infection. While the increased use of HAART may explain the rise in incidence, it is not the only explanation. • All patients, whether they have high cholesterol, high triglycerides, or a combination of the two, should be initially managed with lifestyle modification in the form of diet and exercise. • Lipid-lowering agents can be used successfully in patients when lifestyle modification fails to achieve desired results set forth by the National Cholesterol Education Program (NCEP). Clinicians should be keenly aware of drug-drug interactions when using these agents in this patient population. • There is some efficacy attributed to switching patients to a non-PI-based regimen. Whether or not such an approach will produce long-term results remains unclear. • Patients with HIV infection who do develop dyslipidemias seem to be at low risk for short-term cardiovascular events. However, their long-term outcome in this regard remains unknown.