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HIV infection and lipids

Jain, Anjly; Kolvekar, Trupti; Nair, Devaki, R.

Current Opinion in Cardiology: July 2018 - Volume 33 - Issue 4 - p 429–435
doi: 10.1097/HCO.0000000000000520
LIPIDS AND EMERGING RISK FACTORS: Edited by Dimitri P. Mikhailidis and Anthony S. Wierzbicki

Purpose of review We comment on the role of dyslipidaemia in cardiovascular disease (CVD) in HIV-infected patients. We have discussed various risk factors, including traditional CVD risk factors, HIV-related risk factors and antiretroviral therapy (ART)-induced dyslipidaemia.

Recent findings HIV-infected individuals are prone to lipid and lipoprotein abnormalities as a result of the infection itself and the effect of ART. The older drugs used for the treatment of HIV were associated with an increased risk of these abnormalities. New therapies used to treat HIV are lipid friendly. Calculating CVD risk in the HIV population is complex due to the infection itself and the ART-related factors. The advancement in ART has helped to increase the life expectancy of HIV patients. As a result, a growing number of patients die of non-HIV related complications such as CVD, hepatic and renal disease. Outcome studies with intervention for dyslipidaemia in HIV are underway.

Summary The implications of the above findings suggest that all patients with HIV should undergo a CVD risk assessment before starting ART. Appropriate lipid-friendly ART regimen should be initiated along with intervention for associated CVD risk factors (e.g. lipids, hypertension and smoking).

Department of Clinical Biochemistry, Royal Free London NHS Foundation Trust, London, UK

Correspondence to Dr Devaki R. Nair, BSc, MSc, MBBS, FRCPath, FRCP, Clinical Lead for Clinical Biochemistry (Royal Free and North Middlesex Hospitals), Clinical Lead for Lipids and Cardiovascular Prevention, Director SAS Centre for Cardiac Biomarkers, Royal Free Hospital, Pond Street, London NW3 2QG, UK. Tel: +44 0 2077940500 x33489; e-mail:

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