RESEARCH ARTICLE


New Options in the Treatment of Lipid Disorders in HIV-Infected Patients



Erika Ferrari Rafael da Silva*, 1, Giuseppe Bárbaro2
1 Federal University of São Paulo, R Loefgren, 1588, Zip Code04040 002, São Paulo, Brazil
2 Cardiology Unit, Department of Medical Pathophysiology, University La sapienza, Rome, Italy


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© da Silva and Bárbaro; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Federal University of São Paulo, R Loefgren, 1588, Zip Code04040 002, São Paulo, Brazil; Tel: 55 11 5081 8972; Fax: 55 11 5081 8972; E-mails: erikaferrari@uol.com.br, ferrarierika76@hotmail.com


Abstract

Since the introduction of HAART, there was a remarkably change in the natural history of HIV disease, leading to a notable extension of life expectancy, although prolonged metabolic imbalances could significantly act on the longterm prognosis and outcome of HIV-infected persons, and there is an increasing concern about the cardiovascular risk in this population. Current recommendations suggest that HIV-infected perons undergo evaluation and treatment on the basis of the Third National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (NCEP ATP III) guidelines for dyslipidemia, with particular attention to potential drug interactions with antiretroviral agents and maintenance of virologic control of HIV infection. While a hypolipidemic diet and physical activity may certainly improve dyslipidemia, pharmacological treatment becomes indispensable when serum lipid are excessively high for a long time or the patient has a high cardiovascular risk, since the suspension or change of an effective antiretroviral therapy is not recommended. Moreover, the choice of a hypolipidemic drug is often a reason of concern, since expected drug-drug interactions (especially with antiretroviral agents), toxicity, intolerance, effects on concurrent HIV-related disease and decrease patient adherence to multiple pharmacological regimens must be carefully evaluated. Often the lipid goals of patients in this group are not achieved by the therapy recommended in the current lipid guidelines and in this article we describe other possibilities to treat lipid disorders in HIV-infected persons, like rosuvastatin, ezetimibe and fish oil.

Keywords:: Human immunodefciency virus, acquired immunodeficiency syndrome, highly active antiretroviral therapy, dyslipidemia, statins, fish oil, ezetimibe..