Hyperlipidemia related to the use of HIV-protease inhibitors: natural history and results of treatment with fenofibrate

hyperlipidemia has been frequently recorded as a side effect of treating hiv patients with protease inhibitors (pi). this study was initiated to analyze the modifications on blood lipids in hiv-patients receiving pi and the safety and efficacy of the treatment with fenofibrate. total (tc) and hdl-cholesterol, triglycerides (tg), and cd4+ t-cell counts were measured in 30 haart-naive patients (group i) before and after pi introduction. in a second phase of the study, the effects of fenofibrate on lipids, cpk, cd4+, and viral load were determined in 13 patients (group ii) with elevated tc or tg. in group i, 60% of the patients showed tc or tg elevations. average increments of 31% and 146% in tc and tg respectively (p<0.0006 and p<0.0001) were observed. in group ii, fenofibrate treatment was associated with decrements of 6.6% (tc) and 45.7% (tg) (p=0.07 and 0.0002) and no modifications on cpk, cd4+, and viral load. in conclusion, hyperlipidemia is common during the treatment of hiv with protease inhibitors, and fenofibrate appears to be an effective and safe choice for its treatment.