- Hyperlipidemia refers to high levels of fat in the blood, including cholesterol and triglycerides. Hyperlipidemia increases the risk of heart disease, gall bladder disease, and pancreatitis (inflammation of the pancreas).
- HIV infection and treatment with some HIV medicines can increase the risk of hyperlipidemia. Other risk factors for hyperlipidemia include a family history of hyperlipidemia, a high-fat diet, and smoking.
- Eating foods that are low in saturated fat, trans fat, and cholesterol and being active on most days of the week can help control blood fat levels. Medicines are also used to reduce high blood fat levels.
- In people with HIV, treatment for hyperlipidemia may include changing an HIV regimen to avoid taking HIV medicines that can increase blood fat levels.
What is hyperlipidemia?
Hyperlipidemia is the medical term for high levels of fat in the blood. Fats in the blood (also called lipids) include cholesterol and triglycerides. The body makes cholesterol and triglycerides. The fats also come from some of the foods we eat.
The body needs cholesterol and triglycerides to function properly but having too much can cause problems. High levels of cholesterol and triglycerides increase the risk of heart disease, gall bladder disease, and pancreatitis (inflammation of the pancreas).
What are the symptoms of hyperlipidemia?
Usually hyperlipidemia has no symptoms. A blood test is used to measure levels of fat in the blood and to detect hyperlipidemia.
Testing for hyperlipidemia is recommended both before and after a person starts taking HIV medicines. If blood fat levels are normal, testing is recommended once a year. If blood fat levels are too high, more frequent testing is recommended.
What are risk factors for hyperlipidemia in people with HIV?
HIV infection and treatment with some HIV medicines can increase the risk of hyperlipidemia.
The following HIV medicines can raise blood fat levels:
- All HIV medicines in the protease inhibitor (PI) drug class. (HIV medicines are grouped into drug classes according to how they fight HIV.) The AIDSinfo drug database includes information for all HIV medicines, including those in the PI drug class.
- Efavirenz (brand name: Sustiva), which belongs to the non-nucleoside reverse transcriptase inhibitor (NNRTI) drug class. Efavirenz is one of the components of the combination medicine Atripla. Combination medicines include two or more different HIV medicines in one pill.
- Abacavir (brand name: Ziagen), stavudine (brand name: Zerit), and zidovudine (brand name: Retrovir), which belong to the nucleoside reverse transcriptase inhibitor (NRTI) drug class. Abacavir is a component of the combination medicines Epzicom, Triumeq, and Trizivir. Zidovudine is included in the combination medicines Combivir and Trizivir.
- Stribild, which is a combination medicine that includes three HIV medicines: elvitegravir (brand name: Vitekta), emtricitabine (brand name: Emtriva), and tenofovir disoproxil fumarate (brand name: Viread). Stribild also includes cobicistat (brand name Tybost), a medicine that increases the effectiveness of elvitegravir.
Are there other risk factors for hyperlipidemia?
The following are additional risk factors for hyperlipidemia:
- Family history of hyperlipidemia
- Other medical conditions, including high blood pressure, diabetes, and an underactive thyroid gland
- A high-fat, high-carbohydrate diet
- Being overweight or obese
- Alcohol use
- Lack of physical activity
Many of these risk factors for hyperlipidemia can be controlled by lifestyle choices. For example, maintaining a healthy weight is one way to reduce the risk of hyperlipidemia.
What are other steps a person can take to prevent hyperlipidemia?
Here are additional steps to take to reduce the risk of hyperlipidemia.
- Eat foods low in saturated fat, trans fat, and cholesterol. Eat less full-fat dairy products, fatty meats, and desserts high in fat and sugar. Limit foods that are high in cholesterol, such as egg yolks, fatty meats, and organ meat (like liver and kidney). Instead, choose low-fat or fat-free milk, cheese, and yogurt; eat more foods that are high in fiber, like oatmeal, oat bran, beans, and lentils; and eat more vegetables and fruits.
- Get active. Get at least 30 minutes of aerobic physical activity on most days of the week. Aerobic activities include walking quickly, biking slowly, and gardening.
- If you smoke, quit. Nicotine gum, patches, and lozenges can make it easier to quit. Help is also available over the phone or online. To learn more about strategies to quit smoking, read this fact sheet.
- Drink in moderation. Men should have no more than two alcoholic drinks a day; women no more than one drink. One drink is a glass of wine, a bottle of beer, or a shot of hard liquor.
People who already have hyperlipidemia can also follow these steps to lower their blood fat levels.
What is the treatment for hyperlipidemia?
Lifestyle changes may not be enough to reduce blood fat levels.
In people with HIV, treatment for hyperlipidemia may include changing an HIV regimen to avoid taking HIV medicines that can increase blood fat levels.
There are also medicines that can help control blood fat levels. The most common medicines used to reduce cholesterol levels are called statins. Fibrates are a type of medicine used to lower triglycerides.
HIV medicines can interact with medicines that lower blood fat levels. If you have HIV and need medicine to control hyperlipidemia, your health care provider can recommend medicines that are safe to take with your HIV regimen.
How can I learn more about hyperlipidemia?
This fact sheet is based on information from the following sources: