Question

Is increased cholesterol due to the HIV or the meds?

12 January 2011. Related: All topics, Changing treatment, Drug interactions, Living with HIV long-term, Side effects, Supplements and herbs.

Hi

I started my first line of treatment (Atripla) nearly a year ago. I’ve just been told that my cholesterol has become a problem. The reading came back at 6.3 and I have been told to look at my diet and exercise etc.

I can’t find much area for improvement apart from the fact that the only real exercise I get is a lot of walking as I cannot afford to join a gym or attend exercise classes.

I have been looking at health supplements and found that soya lecithin is an affordable option. An adviser at THT had previously told me that garlic supplement/capsules can interact with Atripla, but was uncertain about soya lecithin. I thought that you might be able to tell me if taking this soya supplement with Atripla would be safe?

I have never had cholesterol problems before – do you think it could be linked to the HIV or the medication?

Many thanks for your help and best wishes

Answer

Answer: Charlotte Walker

Thanks for your question.

Having HIV can affect people’s levels of different lipids (fats) including cholesterol and triglycerides. Starting treatment with any combination will reverse these lipid effects as part of a ‘return-to-health’ but because many HIV drugs also affect lipids this becomes a complex interaction.

There are some things you can do though. As with HIV negative people, and depending on how high your cholesterol is, most doctors first look at diet and exercise. But walking is one of the best exercises you can do, so don’t worry about joining a gym if this is not your preference.

However, YMCA gyms sometimes have specific sessions for HIV positive people called YMCA Positive Health. These sessions are generally cheaper than other gym sessions and if you able to go during working hours they are even cheaper. You can be referred by your doctor or just go along. The sessions are specifically designed for people who are HIV positive and so those that run the sessions are usually aware of health issues affecting people with HIV such as increased cholesterol. If you are not openly positive I can understand that you might not feel comfortable about joining these sessions. Increasing the amount you are walking/cycling/running are all good alternatives. For more information here is an article about someone who has used the YMCA Positive Health services.

If diet an exercise font improve your results, you could either switch meds (usually the efavirenz to an alternative) or use a lipid-lowering drugs like a statin. For more information about cholesterol levels and treatments please follow this link.

There is no interaction with soya lecithin and Atripla so it is safe to take this supplement.

Best wishes and please let us know how you get on