Dyslipidemia

Patients infected with HIV often develop dyslipidemia. Although lipid abnormalities have been described in HIV-infected patients from the pre-combination antiretroviral therapy era, they are most striking in patients treated with antiretroviral drugs and may even be present in those not exposed to these drugs. The dyslipidemic profile in HIV includes abnormalities in lipids and lipoprotein, including hypertriglyceridemia, elevated plasma total low-density lipoprotein cholesterol concentrations, and low levels of high-density lipoprotein cholesterol. Many patients also have the phenotypic appearance of lipodystrophy, with a variable combination of centripetal fat accumulation. The consequence of an abnormal dyslipidemic profile in the HIV lipodystrophic patient is an accelerated risk of developing myocardial infarction, cardiovascular disease, nonalcoholic fatty liver disease, and type 2 diabetes.