To the researchers' surprise, total and LDL cholesterol levels, which dropped after HIV infection, returned to normal with HAART. However, at the end of the study, triglyeride levels in the blood, another heart disease risk factor, were higher than those of HIV-negative men of the same age, and levels of HDL cholesterol, the "good cholesterol" were lower than those of uninfected men. As a result, increased risk of heart attack and stroke may still be a concern for those on HAART, albeit a lesser one than previously thought. Below, lead study author Sharon Riddler, MD, MPH, an associate professor of medicine at the University of Pittsburgh, discusses the study findings and what they mean for people with HIV.
When did doctors begin to notice a change in cholesterol levels in their HIV patients?
The history of this goes back to about mid-1996, when protease inhibitors, which are one of the classes of HIV medications that we use, became available. About two years later, the first reports emerged about some changes that were being observed. One of the changes was elevations in cholesterol levels and triglyceride levels.
Why is elevated cholesterol a concern for people with HIV?
The concern was that we were making people healthier from an HIV standpoint, but we were creating new problems by putting people at risk for cardiovascular disease. Additionally, elevated triglycerides can cause pancreatitis, a painful inflammation of the pancreas.
