When and why

Lipid is a general term for fat. Lipids include various types of cholesterol, phospholipids and triglycerides. Lipids are carried in the blood as lipoproteins. A lipid test is a type of blood test.

In untreated HIV disease, cholesterol levels fall and triglycerides levels rise as the disease progresses. However, in the age of antiretroviral therapy, both cholesterol and triglyceride levels can become dangerously high. High lipids increase the risk of blood clots, heart disease and heart attack, stroke, and pancreatitis.

Consequently, if you are on treatment, your doctor will want to monitor your lipids to identify and manage rising lipids. If you have not taken anti-HIV drugs, your lipids should be measured before you start treatment.

Whats involved?

Lipid tests are done on an empty stomach, and results are called fasting levels. Triglyceride levels are always higher after a meal.

Normal range for total cholesterol is 2.3 - 5.8 mmol/l. Normal range for HDL levels ('good' cholesterol) in women is 1.0 - 2.0 mmol/l and 0.7 - 1.6 mmol/l in men. To obtain US measurements in mg/dL, multiply these figures by 38.6. The normal range for triglyceride is 0.5 -1.8 mm/l while 1.8 - 4.5 mm/l is normal to high.

How it will help

If triglycerides are very high, lipid-lowering drugs may be used, although the effectiveness of these treatments in people on anti-HIV drugs has not been fully established. Your doctor may also discuss with you lifestyle and dietary changes which can help reduce lipid levels, e.g. increasing exercise, stopping smoking, reducing fat in the diet. Changing therapy may also be an option.

See Measuring fats and sugar abnormalities in Anti-HIV therapy: Body fat and metabolic changes whilst on treatment for more details.