Skip to main content
SpringerLink
Log in

Diagnosis and Management of Dyslipidemia

  • Chapter
  • First Online:
Cardiovascular Care in Patients With HIV

  • 317 Accesses

Abstract

The development and use of antiretroviral medications to treat patients infected with HIV have dramatically changed the course of this disease from one that was fatal to a chronic and more manageable condition. Recent epidemiologic studies have shown that people infected with HIV have an increased risk of CVD at all ages compared to the general population that remains even after control of traditional risk factors. It is anticipated that CVD will become the leading cause of morbidity and mortality in this patient population making diagnosis and management of CVD risk factors, in particular dyslipidemia, essential to patient care.

While HIV medical associations have made recommendations, there are no specific and comprehensive guidelines or risk stratification schemes for management of dyslipidemia in patients infected with HIV. Recommendations and guidelines for the general population are presented in this review with suggestions as to how they may be applied to this patient population. Issues for which there is little or no information available are noted to highlight the many gaps in our knowledge regarding diagnosis and management of dyslipidemia for patients living with HIV.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Galescu O, Bhangoo A, Ten S. Insulin resistance, lipodystrophy and cardiometabolic syndrome in HIV/AIDS. Rev Endocr Metab Disord. 2013;14(2):133–40.

    Article  CAS  PubMed  Google Scholar 

  2. Reyskens KM, Essop MF. The maladaptive effects of HIV protease inhibitors (lopinavir/ritonavir) on the rat heart. Int J Cardiol. 2013;168(3):3047–9.

    Article  PubMed  Google Scholar 

  3. Grinspoon SK, Grunfeld C, Kotler DP, et al. State of the science conference: initiative to decrease cardiovascular risk and increase quality of care for patients living with HIV/AIDS: executive summary. Circulation. 2008;118(2):198–210.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Magkos F, Mantzoros CS. Body fat redistribution and metabolic abnormalities in HIV-infected patients on highly active antiretroviral therapy: novel insights into pathophysiology and emerging opportunities for treatment. Metab Clin Exp. 2011;60(6):749–53.

    Article  CAS  PubMed  Google Scholar 

  5. Brown TT, Tassiopoulos K, Bosch RJ, Shikuma C, McComsey GA. Association between systemic inflammation and incident diabetes in HIV-infected patients after initiation of antiretroviral therapy. Diabetes Care. 2010;33(10):2244–9.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Libby P, Ridker P. Inflammation and atherothrombosis: from population biology and bench research to clinical practice. J Am Coll Cardiol. 2006;48(9, Supplement A):A33–46.

    Article  CAS  Google Scholar 

  7. El-Sadr WM, Lundgren J, Neaton JD, et al. CD4+ count-guided interruption of antiretroviral treatment. N Engl J Med. 2006;355(22):2283–96.

    Article  CAS  PubMed  Google Scholar 

  8. Kuller LH, Tracy R, Belloso W, et al. Inflammatory and coagulation biomarkers and mortality in patients with HIV infection. PLoS Med. 2008;5(10):e203.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  9. Stein JH, Komarow L, Cotter BR, et al. Lipoprotein changes in HIV-infected antiretroviral-naive individuals after starting antiretroviral therapy: ACTG study A5152s Stein: lipoprotein changes on antiretroviral therapy. J Clin Lipidol. 2008;2(6):464–71.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Riddler SA, Li X, Chu H, et al. Longitudinal changes in serum lipids among HIV-infected men on highly active antiretroviral therapy. HIV Med. 2007;8(5):280–7.

    Article  CAS  PubMed  Google Scholar 

  11. Riddler SA, Smit E, Cole SR, et al. Impact of HIV infection and HAART on serum lipids in men. JAMA. 2003;289(22):2978–82.

    Article  CAS  PubMed  Google Scholar 

  12. Jarrett OD, Wanke CA, Ruthazer R, Bica I, Isaac R, Knox TA. Metabolic syndrome predicts all-cause mortality in persons with human immunodeficiency virus. AIDS Patient Care STDs. 2013;27(5):266–71.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Alencastro PR, Fuchs SC, Wolff FH, Ikeda ML, Brandao AB, Barcellos NT. Independent predictors of metabolic syndrome in HIV-infected patients. AIDS Patient Care STDs. 2011;25(11):627–34.

    Article  PubMed  Google Scholar 

  14. Friis-Moller N, Reiss P, Sabin CA, et al. Class of antiretroviral drugs and the risk of myocardial infarction. N Engl J Med. 2007;356(17):1723–35.

    Article  PubMed  Google Scholar 

  15. Martin Lde S, Pasquier E, Roudaut N, et al. Metabolic syndrome: a major risk factor for atherosclerosis in HIV-infected patients (SHIVA study). Presse Med (Paris, France: 1983). 2008;37(4 Pt 1):579–84.

    Article  Google Scholar 

  16. Malvestutto CD, Aberg JA. Management of dyslipidemia in HIV-infected patients. Clin Lipidol. 2011;6(4):447–62.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Dube MP, Stein JH, Aberg JA, et al. Guidelines for the evaluation and management of dyslipidemia in human immunodeficiency virus (HIV)-infected adults receiving antiretroviral therapy: recommendations of the HIV Medical Association of the Infectious Disease Society of America and the Adult AIDS Clinical Trials Group. Clin Infect Dis. 2003;37(5):613–27.

    Article  PubMed  Google Scholar 

  18. Aberg JA, Gallant JE, Ghanem KG, Emmanuel P, Zingman BS, Horberg MA. Primary care guidelines for the management of persons infected with HIV: 2013 update by the HIV medicine association of the Infectious Diseases Society of America. Clin Infect Dis. 2014;58(1):e1–34.

    Article  PubMed  Google Scholar 

  19. Jacobson TA, Maki KC, Orringer CE, et al. National lipid association recommendations for patient-centered management of dyslipidemia: part 2. J Clin Lipidol. 2015;9(6 Suppl):S1–S122.e121.

    Article  PubMed  Google Scholar 

  20. Friis-Moller N, Thiebaut R, Reiss P, et al. Predicting the risk of cardiovascular disease in HIV-infected patients: the data collection on adverse effects of anti-HIV drugs study. Eur J Cardiovasc Prev Rehabil. 2010;17(5):491–501.

    Article  PubMed  Google Scholar 

  21. Justice AC, Freiberg MS, Tracy R, et al. Does an index composed of clinical data reflect effects of inflammation, coagulation, and monocyte activation on mortality among those aging with HIV? Clin Infect Dis. 2012;54(7):984–94.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Pasternak RC. Report of the adult treatment panel III: the 2001 National Cholesterol Education Program guidelines on the detection, evaluation and treatment of elevated cholesterol in adults. Cardiol Clin. 2003;21(3):393–8.

    Article  PubMed  Google Scholar 

  23. Catapano AL, Chapman J, Wiklund O, Taskinen MR. The new joint EAS/ESC guidelines for the management of dyslipidaemias. Atherosclerosis. 2011;217(1):1.

    Article  CAS  PubMed  Google Scholar 

  24. Anderson TJ, Gregoire J, Hegele RA, et al. 2012 update of the Canadian Cardiovascular Society guidelines for the diagnosis and treatment of dyslipidemia for the prevention of cardiovascular disease in the adult. Can J Cardiol. 2013;29(2):151–67.

    Article  PubMed  Google Scholar 

  25. An International Atherosclerosis Society Position Paper: global recommendations for the management of dyslipidemia – full report. J Clin Lipidol. 2014;8(1):29–60.

    Google Scholar 

  26. Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation. 2002;106(25):3143–3421.

    Google Scholar 

  27. Stone NJ, Robinson J, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. J Am Coll Cardiol. 2014;63:2889–934.

    Google Scholar 

  28. Jacobson TA, Ito MK, Maki KC, et al. National Lipid Association recommendations for patient-centered management of dyslipidemia: part 1 – executive summary. J Clin Lipidol. 2014;8(5):473–88.

    Article  PubMed  Google Scholar 

  29. Lundgren JD, Battegay M, Behrens G, et al. European AIDS Clinical Society (EACS) guidelines on the prevention and management of metabolic diseases in HIV. HIV Med. 2008;9(2):72–81.

    Article  CAS  PubMed  Google Scholar 

  30. Otvos JD, Mora S, Shalaurova I, Greenland P, Mackey RH, Goff DC Jr. Clinical implications of discordance between low-density lipoprotein cholesterol and particle number. J Clin Lipidol. 2011;5(2):105–13.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Cromwell WC, Otvos JD, Keyes MJ, et al. LDL particle number and risk of future cardiovascular disease in the Framingham Offspring Study – implications for LDL management. J Clin Lipidol. 2007;1(6):583–92.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Manickam P, Rathod A, Panaich S, et al. Comparative prognostic utility of conventional and novel lipid parameters for cardiovascular disease risk prediction: do novel lipid parameters offer an advantage? J Clin Lipidol. 2011;5(2):82–90.

    Article  PubMed  Google Scholar 

  33. Malave H, Castro M, Burkle J, et al. Evaluation of low-density lipoprotein particle number distribution in patients with type 2 diabetes mellitus with low-density lipoprotein cholesterol <50 mg/dl and non-high-density lipoprotein cholesterol <80 mg/dl. Am J Cardiol. 2012;110(5):662–5.

    Article  CAS  PubMed  Google Scholar 

  34. Myerson M, Lee R, Varela D, et al. Lipoprotein measurements in patients infected with HIV: is cholesterol content of HDL and LDL discordant with particle number? J Clin Lipidol. 2014;8(3):332–3.

    Article  Google Scholar 

  35. Swanson B, Sha BE, Keithley JK, et al. Lipoprotein particle profiles by nuclear magnetic resonance spectroscopy in medically-underserved HIV-infected persons. J Clin Lipidol. 2009;3(6):379–84.

    Article  PubMed Central  PubMed  Google Scholar 

  36. Miller M, Stone NJ, Ballantyne C, et al. Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2011;123(20):2292–333.

    Article  PubMed  Google Scholar 

  37. Bucher HC, Richter W, Glass TR, et al. Small dense lipoproteins, apolipoprotein B, and risk of coronary events in HIV-infected patients on antiretroviral therapy: the Swiss HIV Cohort Study. J Acquir Immune Defic Syndr (1999). 2012;60(2):135–42.

    Article  CAS  Google Scholar 

  38. Anastos K, Lu D, Shi Q, et al. Association of serum lipid levels with HIV serostatus, specific antiretroviral agents, and treatment regimens. J Acquir Immune Defic Syndr (1999). 2007;45(1):34–42.

    Article  CAS  Google Scholar 

  39. Hegele RA, Ginsberg HN, Chapman MJ, et al. The polygenic nature of hypertriglyceridaemia: implications for definition, diagnosis, and management. Lancet Diabetes Endocrinol. 2013;

    Google Scholar 

  40. Stein JH, Merwood MA, Bellehumeur JB, McBride PE, Wiebe DA, Sosman JM. Postprandial lipoprotein changes in patients taking antiretroviral therapy for HIV infection. Arterioscler Thromb Vasc Biol. 2005;25(2):399–405.

    Article  CAS  PubMed  Google Scholar 

  41. Anuurad E, Thomas-Geevarghese A, Devaraj S, et al. Increased lipoprotein remnant cholesterol levels in HIV-positive patients during antiretroviral therapy. Atherosclerosis. 2008;198(1):192–7.

    Article  CAS  PubMed  Google Scholar 

  42. Toth PP, Barter PJ, Rosenson RS, et al. High-density lipoproteins: a consensus statement from the National Lipid Association. J Clin Lipidol. 2013;7(5):484–525.

    Article  PubMed  Google Scholar 

  43. Davidson MH, Ballantyne CM, Jacobson TA, et al. Clinical utility of inflammatory markers and advanced lipoprotein testing: advice from an expert panel of lipid specialists. J Clin Lipidol. 2011;5(5):338–67.

    Article  PubMed  Google Scholar 

  44. Baruch L, Agarwal S, Gupta B, et al. Is directly measured low-density lipoprotein clinically equivalent to calculated low-density lipoprotein? J Clin Lipidol. 2010;4(4):259–64.

    Article  PubMed  Google Scholar 

  45. Marzilli M. Pleiotropic effects of statins: evidence for benefits beyond LDL-cholesterol lowering. Am J Cardiovasc Drugs. 2010;10(Suppl 1):3–9.

    Article  CAS  PubMed  Google Scholar 

  46. Aberg JA, Zackin RA, Brobst SW, et al. A randomized trial of the efficacy and safety of fenofibrate versus pravastatin in HIV-infected subjects with lipid abnormalities: AIDS Clinical Trials Group Study 5087. AIDS Res Hum Retrovir. 2005;21(9):757–67.

    Article  CAS  PubMed  Google Scholar 

  47. Calza L, Manfredi R, Colangeli V, et al. Two-year treatment with rosuvastatin reduces carotid intima-media thickness in HIV type 1-infected patients receiving highly active antiretroviral therapy with asymptomatic atherosclerosis and moderate cardiovascular risk. AIDS Res Hum Retrovir. 2013;29(3):547–56.

    Article  CAS  PubMed  Google Scholar 

  48. Aslangul E, Assoumou L, Bittar R, et al. Rosuvastatin versus pravastatin in dyslipidemic HIV-1-infected patients receiving protease inhibitors: a randomized trial. AIDS. 2010;24(1):77–83.

    Article  CAS  PubMed  Google Scholar 

  49. Erlandson KM, Jiang Y, Debanne SM, McComsey GA. Rosuvastatin worsens insulin resistance in HIV-infected adults on antiretroviral therapy. Clin Infect Dis. 2015;61(10):1566–72.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  50. Aberg JA, Sponseller CA, Ward DJ, Kryzhanovski VA, Campbell SE, Thompson MA. Pitavastatin versus pravastatin in adults with HIV-1 infection and dyslipidaemia (INTREPID): 12 week and 52 week results of a phase 4, multicentre, randomised, double-blind, superiority trial. Lancet HIV. 2017;4(7):e284–94.

    Article  PubMed  Google Scholar 

  51. Sponseller CA, Tanahashi M, Suganami H, Aberg JA. Pitavastatin 4 mg vs. pravastatin 40 mg in HIV: dyslipidemia: post-hoc analysis of the INTREPID trial based on the independent CHD risk factor of age. National Lipid Association Annual Scientific Sessions, May 1–4, 2014; Orlando.

    Google Scholar 

  52. Aberg JA, Sponseller CA. Neutral effects of Pitavasatatin 4 grams and pravastatin 40 mg on blood glucose levels over 12 weeks. Prescpecified safety analysis from INTREPID June 16, 2013; San Francisco.

    Google Scholar 

  53. Bays H, Cohen DE, Chalasani N, Harrison SA. An assessment by the statin liver safety task force: 2014 update. J Clin Lipidol. 2014;8(3 Suppl):S47–57.

    Article  PubMed  Google Scholar 

  54. Rosenson RS, Baker SK, Jacobson TA, Kopecky SL, Parker BA. An assessment by the statin muscle safety task force: 2014 update. J Clin Lipidol. 2014;8(3 Suppl):S58–71.

    Article  PubMed  Google Scholar 

  55. Neal RC, Ferdinand KC, Ycas J, Miller E. Relationship of ethnic origin, gender, and age to blood creatine kinase levels. Am J Med. 2009;122(1):73–8.

    Article  CAS  PubMed  Google Scholar 

  56. Duggan ST. Pitavastatin: a review of its use in the management of hypercholesterolaemia or mixed dyslipidaemia. Drugs. 2012;72(4):565–84.

    Article  CAS  PubMed  Google Scholar 

  57. Administration UFaD. FDA drug safey communication: important safety label changes to cholesterol-lowering statin drugs. Rockville: US Food and Drug Administration.

    Google Scholar 

  58. Chan P, Brew BJ. HIV associated neurocognitive disorders in the modern antiviral treatment era: prevalence, characteristics, biomarkers, and effects of treatment. Curr HIV/AIDS Rep. 2014;11(3):317–24.

    Article  PubMed  Google Scholar 

  59. Sattar N, Ginsberg HN, Ray KK. The use of statins in people at risk of developing diabetes mellitus: evicence and guideance for clinical practice. Atheroscler Suppl. 2014;15(1):1–15.

    Article  PubMed  Google Scholar 

  60. Lloyd-Jones DM, Morris PB, Ballantyne CM, et al. 2016 ACC expert consensus decision pathway on the role of non-statin therapies for LDL-cholesterol lowering in the Management of Atherosclerotic Cardiovascular Disease Risk: a report of the American College of Cardiology Task Force on clinical expert consensus documents. J Am Coll Cardiol. 2016;68(1):92–125.

    Article  PubMed  Google Scholar 

  61. Sweeney ME, Johnson RR. Ezetimibe: an update on the mechanism of action, pharmacokinetics and recent clinical trials. Expert Opin Drug Metab Toxicol. 2007;3(3):441–50.

    Article  CAS  PubMed  Google Scholar 

  62. Cannon C. Improved reduction of outcomes: vytorin efficiacy international trial American Heart Association November 17, 2014. 2014; Chicago.

    Google Scholar 

  63. Coll B, Aragones G, Parra S, Alonso-Villaverde C, Masana L. Ezetimibe effectively decreases LDL-cholesterol in HIV-infected patients. AIDS. 2006;20(12):1675–7.

    Article  CAS  PubMed  Google Scholar 

  64. Bennett MT, Johns KW, Bondy GP. Ezetimibe is effective when added to maximally tolerated lipid lowering therapy in patients with HIV. Lipids Health Dis. 2007;6:15.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  65. Chow D, Chen H, Glesby MJ, et al. Short-term ezetimibe is well tolerated and effective in combination with statin therapy to treat elevated LDL cholesterol in HIV-infected patients. AIDS. 2009;23(16):2133–41.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  66. Digby JE, Ruparelia N, Choudhury RP. Niacin in cardiovascular disease: recent preclinical and clinical developments. Arterioscler Thromb Vasc Biol. 2012;32(3):582–8.

    Article  CAS  PubMed  Google Scholar 

  67. Brunzell JD. Clinical practice. Hypertriglyceridemia. N Engl J Med. 2007;357(10):1009–17.

    Article  CAS  PubMed  Google Scholar 

  68. Rajanna V, Campbell KB, Leimberger J, Mohanty BD, Guyton JR. Elevation of fasting morning glucose relative to hemoglobin A1c in normoglycemic patients treated with niacin and with statins. J Clin Lipidol. 2012;6(2):168–73.

    Article  PubMed  Google Scholar 

  69. Guyton JR, Bays HE. Safety considerations with niacin therapy. Am J Cardiol. 2007;99(6A):22C–31C.

    Article  CAS  PubMed  Google Scholar 

  70. Meyers CD, Carr MC, Park S, Brunzell JD. Varying cost and free nicotinic acid content in over-the-counter niacin preparations for dyslipidemia. Ann Intern Med. 2003;139(12):996–1002.

    Article  PubMed  Google Scholar 

  71. Canner PL, Berge KG, Wenger NK, et al. Fifteen year mortality in coronary drug project patients: long-term benefit with niacin. J Am Coll Cardiol. 1986;8(6):1245–55.

    Article  CAS  PubMed  Google Scholar 

  72. Boden WE, Probstfield JL, Anderson T, et al. Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. N Engl J Med. 2011;365(24):2255–67.

    Article  CAS  PubMed  Google Scholar 

  73. Landray MJ, Haynes R, Hopewell JC, et al. Effects of extended-release niacin with laropiprant in high-risk patients. N Engl J Med. 2014;371(3):203–12.

    Article  CAS  PubMed  Google Scholar 

  74. Dube MP, Wu JW, Aberg JA, et al. Safety and efficacy of extended-release niacin for the treatment of dyslipidaemia in patients with HIV infection: AIDS Clinical Trials Group Study A5148. Antivir Ther. 2006;11(8):1081–9.

    CAS  PubMed Central  PubMed  Google Scholar 

  75. Gerber MT, Mondy KE, Yarasheski KE, et al. Niacin in HIV-infected individuals with hyperlipidemia receiving potent antiretroviral therapy. Clin Infect Dis. 2004;39(3):419–25.

    Article  CAS  PubMed  Google Scholar 

  76. Tunjungputri RN, Van Der Ven AJ, Schonsberg A, et al. Reduced platelet hyperreactivity and platelet-monocyte aggregation in HIV-infected individuals receiving a raltegravir-based regimen. AIDS. 2014;28(14):2091–6.

    Article  CAS  PubMed  Google Scholar 

  77. Krishnan S, Schouten JT, Atkinson B, et al. Changes in metabolic syndrome status after initiation of antiretroviral therapy. J Acquir Immune Defic Syndr (1999). 2015;68(1):73–80.

    Article  CAS  Google Scholar 

  78. Nakagomi-Hagihara R, Nakai D, Tokui T, Abe T, Ikeda T. Gemfibrozil and its glucuronide inhibit the hepatic uptake of pravastatin mediated by OATP1B1. Xenobiotica. 2007;37(5):474–86.

    Article  CAS  PubMed  Google Scholar 

  79. Attridge RL, Frei CR, Ryan L, Koeller J, Linn WD. Fenofibrate-associated nephrotoxicity: a review of current evidence. Am J Health Syst Pharm. 2013;70(14):1219–25.

    Article  CAS  PubMed  Google Scholar 

  80. Calza L, Manfredi R, Chiodo F. Use of fibrates in the management of hyperlipidemia in HIV-infected patients receiving HAART. Infection. 2002;30(1):26–31.

    Article  CAS  PubMed  Google Scholar 

  81. Palacios R, Santos J, Gonzalez M, et al. Efficacy and safety of fenofibrate for the treatment of hypertriglyceridemia associated with antiretroviral therapy. J Acquir Immune Defic Syndr (1999). 2002;31(2):251–3.

    Article  Google Scholar 

  82. Bays HE, Tighe AP, Sadovsky R, Davidson MH. Prescription omega-3 fatty acids and their lipid effects: physiologic mechanisms of action and clinical implications. Expert Rev Cardiovasc Ther. 2008;6(3):391–409.

    Article  CAS  PubMed  Google Scholar 

  83. Isosapent ethyl (Vascepa) for severe hypertriglyceridemia. Med Lett. 2013;55:33–34.

    Google Scholar 

  84. Wohl DA, Tien HC, Busby M, et al. Randomized study of the safety and efficacy of fish oil (omega-3 fatty acid) supplementation with dietary and exercise counseling for the treatment of antiretroviral therapy-associated hypertriglyceridemia. Clin Infect Dis. 2005;41(10):1498–504.

    Article  CAS  PubMed  Google Scholar 

  85. De Truchis P, Kirstetter M, Perier A, et al. Reduction in triglyceride level with N-3 polyunsaturated fatty acids in HIV-infected patients taking potent antiretroviral therapy: a randomized prospective study. J Acquir Immune Defic Syndr (1999). 2007;44(3):278–85.

    Article  CAS  Google Scholar 

  86. Peters BS, Wierzbicki AS, Moyle G, Nair D, Brockmeyer N. The effect of a 12-week course of omega-3 polyunsaturated fatty acids on lipid parameters in hypertriglyceridemic adult HIV-infected patients undergoing HAART: a randomized, placebo-controlled pilot trial. Clin Ther. 2012;34(1):67–76.

    Article  CAS  PubMed  Google Scholar 

  87. Gerber JG, Kitch DW, Fichtenbaum CJ, et al. Fish oil and fenofibrate for the treatment of hypertriglyceridemia in HIV-infected subjects on antiretroviral therapy: results of ACTG A5186. J Acquir Immune Defic Syndr (1999). 2008;47(4):459–66.

    Article  CAS  Google Scholar 

  88. Munoz MA, Liu W, Delaney JA, et al. Comparative effectiveness of fish oil versus fenofibrate, gemfibrozil, and atorvastatin on lowering triglyceride levels among HIV-infected patients in routine clinical care. J Acquir Immune Defic Syndr (1999). 2013;64(3):254–60.

    Article  CAS  Google Scholar 

  89. Goldberg AC, Hopkins PN, Toth PP, et al. Familial hypercholesterolemia: screening, diagnosis and management of pediatric and adult patients: clinical guidance from the National Lipid Association Expert Panel on Familial Hypercholesterolemia. J Clin Lipidol. 2011;5(3 Suppl):S1–8.

    Article  PubMed  Google Scholar 

  90. Nguyen ST, Eaton SA, Bain AM, et al. Lipid-lowering efficacy and safety after switching to atazanavir-ritonavir-based highly active antiretroviral therapy in patients with human immunodeficiency virus. Pharmacotherapy. 2008;28(3):323–30.

    Article  CAS  PubMed  Google Scholar 

  91. Bain AM, White EA, Rutherford WS, Rahman AP, Busti AJ. A multimodal, evidence-based approach to achieve lipid targets in the treatment of antiretroviral-associated dyslipidemia: case report and review of the literature. Pharmacotherapy. 2008;28(7):932–8.

    Article  CAS  PubMed  Google Scholar 

  92. Myerson M, Malvestutto C, Aberg JA. Management of lipid disorders in patients living with HIV. J Clin Pharmacol. 2015;55:957–74.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiology, Bassett Medical Center, Bassett Research Institute, Center for Clinical Research, Cooperstown, NY, USA

    Merle Myerson

Authors
  1. Merle Myerson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Merle Myerson .

Editor information

Editors and Affiliations

  1. Bassett Research Institute, Bassett Medical Center, Cooperstown, NY, USA

    Merle Myerson

  2. Division of Infectious Diseases, Weill Cornell Medical College, New York, NY, USA

    Marshall J. Glesby

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Myerson, M. (2019). Diagnosis and Management of Dyslipidemia. In: Myerson, M., Glesby, M. (eds) Cardiovascular Care in Patients With HIV. Springer, Cham. https://doi.org/10.1007/978-3-030-10451-1_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-10451-1_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-10450-4

  • Online ISBN: 978-3-030-10451-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation