TY - JOUR
T1 - Guidelines for the evaluation and management of dyslipidemia in human immunodeficiency virus (HIV)-infected adults receiving antiretroviral therapy
T2 - Recommendations of the HIV Medicine Association of the Infectious Disease Society of America and the Adult AIDS Clinical Trials Group
AU - Dubé, Michael P.
AU - Stein, James H.
AU - Aberg, Judith A.
AU - Fichtenbaum, Carl J.
AU - Gerber, John G.
AU - Tashima, Karen T.
AU - Henry, W. Keith
AU - Currier, Judith S.
AU - Sprecher, Dennis
AU - Glesby, Marshall J.
PY - 2003/9/1
Y1 - 2003/9/1
N2 - Dyslipidemia is a common problem affecting HIV-infected patients receiving antiretroviral therapy. Since publication of preliminary guidelines in 2000 [1], numerous studies have addressed the risk of cardiovascular disease, the mechanisms of dyslipidemia, drug interactions, and the treatment of lipid disorders in HIV-infected patients. In addition, updated recommendations from the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III [ATP III]) have been published [2] that materially affect the clinical approach to lipid disorders in the general population. A working group of clinical scientists, consisting of members of the Cardiovascular Subcommittee of the AIDS Clinical Trials Group, updated the preliminary recommendations to assist clinicians in the evaluation and treatment of lipid disorders among HIV-infected adults. Data regarding the prevalence and incidence of dyslipidemia and cardiovascular disease in HIV-infected patients, pharmacokinetic profiles for hypolipidemic agents, and treatment trials of dyslipidemia in HIV-infected patients were considered. Although the implications of dyslipidemia in this population are not fully known, preliminary data indicate increased cardiovascular morbidity among HIV-infected individuals, suggesting that measures to reduce cardiovascular risk should be provided. We recommend that HIV-infected adults undergo evaluation and treatment on the basis of NCEP ATP III guidelines for dyslipidemia, with particular attention to potential drug interactions with antiretroviral agents and maintenance of virologic control of HIV infection. When drugs become necessary, we recommend as initial therapy pravastatin or atorvastatin for elevated low-density lipoprotein cholesterol levels and gemfibrozil or fenofibrate when triglyceride concentrations exceed 500 mg/dL.
AB - Dyslipidemia is a common problem affecting HIV-infected patients receiving antiretroviral therapy. Since publication of preliminary guidelines in 2000 [1], numerous studies have addressed the risk of cardiovascular disease, the mechanisms of dyslipidemia, drug interactions, and the treatment of lipid disorders in HIV-infected patients. In addition, updated recommendations from the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III [ATP III]) have been published [2] that materially affect the clinical approach to lipid disorders in the general population. A working group of clinical scientists, consisting of members of the Cardiovascular Subcommittee of the AIDS Clinical Trials Group, updated the preliminary recommendations to assist clinicians in the evaluation and treatment of lipid disorders among HIV-infected adults. Data regarding the prevalence and incidence of dyslipidemia and cardiovascular disease in HIV-infected patients, pharmacokinetic profiles for hypolipidemic agents, and treatment trials of dyslipidemia in HIV-infected patients were considered. Although the implications of dyslipidemia in this population are not fully known, preliminary data indicate increased cardiovascular morbidity among HIV-infected individuals, suggesting that measures to reduce cardiovascular risk should be provided. We recommend that HIV-infected adults undergo evaluation and treatment on the basis of NCEP ATP III guidelines for dyslipidemia, with particular attention to potential drug interactions with antiretroviral agents and maintenance of virologic control of HIV infection. When drugs become necessary, we recommend as initial therapy pravastatin or atorvastatin for elevated low-density lipoprotein cholesterol levels and gemfibrozil or fenofibrate when triglyceride concentrations exceed 500 mg/dL.
UR - http://www.scopus.com/inward/record.url?scp=0042832397&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0042832397&partnerID=8YFLogxK
U2 - 10.1086/378131
DO - 10.1086/378131
M3 - Review article
C2 - 12942391
AN - SCOPUS:0042832397
SN - 1058-4838
VL - 37
SP - 613
EP - 627
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 5
ER -
