HIV, HAART and metabolic changes

  • The level of fats in the blood (lipids) may be affected by antiretroviral treatment. Sometimes they rise far above normal levels and need to be treated by changes in diet, exercise or drugs. An increase to a very high level is especially likely if your levels are already quite high.
  • All protease inhibitors, with the exception of atazanavir (Reyataz) increase lipid levels in the majority of people who take them.
  • Rises in cholesterol and triglyceride (the two main types of lipids) may put you at higher risk of heart disease, especially in people who smoke, are overweight or have high blood pressure. Older people are also at higher risk of heart disease when these blood fats, or lipids, go up.
  • Lipid levels should be tested before starting antiretroviral treatment, and regularly once treatment is begun. They should be tested first thing in the morning before breakfast to get the most accurate measure: this will show the absolute minimum level. Triglyceride levels also need to be tested after a meal, because they rise very high within an hour or so of eating.
  • Very high levels of the triglycerides may cause pancreatitis, a life-threatening illness.
  • Changes in glucose metabolism (the way the body handles sugar) can also occur on protease inhibitor treatment. The most severe change is the development of diabetes, a serious disorder. This has happened in around 1 to 4% of people in studies, but less serious changes in sugar levels and sugar metabolism also occur. These changes can cause tiredness, poor concentration and loss of strength.
This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.