Dyslipidaemia associated with the highly active antiretroviral therapy in aids patient: reversion after switching (stavudine to tenofovir and lopinavir/ritonavir to atazanavir/ritonavir)

Abstract

Antiretroviral therapy has been associated with hyperlipidemia in AIDS patients. This case illustrates the classic metabolic effects associated to the HAART including protease inhibitors and/or stavudine. It was showed that the management of the HAART-associated dyslipidaemia with conventional antihyperlipidemic therapy may fail, being the switching strategy the best option.

Perfil nutricional de pacientes soropositivos em uso de antirretroviral

“…Portanto, o HIV por si já é responsável por causar dislipidemias em mais de 50% dos casos, tornando o efeito colateral da HAART muito mais significativo, podendo aumentar o risco cardiovascular e comprometer a qualidade de vida de seus usuários [18].…”

“…Antes do advento da HAART, as manifestações cardiovasculares mais comuns incluíam cardiomiopatia dilatada, endocardites, miocardites, pericardites, ICC direita causada por hipertensão pulmonar, alterações no sistema de condução do coração e neoplasias infiltrativas como linfomas ou sarcoma de Kaposi [18].…”

Alcoholic Extract of Lotus Leaves Improves Lipid Profile in Rats with HIV Protease Inhibitor-induced Dyslipidemia

“…Lifestyle changes such as smoking cessation, dietary intervention and aerobic physical activity should be introduced to patients (8,9), but lifestyle changes may have minor effects in reducing lipids to the normal range (10)(11)(12). Switching antiretroviral drugs should only be considered when there is a viable alternative antiretroviral regimen, and the new regimen is likely to induce less dyslipidaemia than the original and is likely to possess similar or enhanced antiretroviral potency compared to the original regimen (13,14). In addition, because of the multifactorial nature of dyslipidaemia in HIV infection, abnormal lipid profile may not be resolved simply by switching drugs (8).…”