Be Aggressive!

An aggressive approach toward lowering cardiovascular risk factors among HIVers--including one or more lipid-lowering medications, antiplatelet therapies, and changing from other protease inhibitors to Reyataz, which has less impact on lipid levels--achieves much greater reductions in "bad" LDL cholesterol levels than a more standard approach, according to a study presented at the 2009 IAS Conference. After 12 months of aggressive treatment, study subjects' mean LDL cholesterol levels dropped by nearly 38%, and decreases in blood-based levels of C-reactive protein, a biomarker for heart disease, also were recorded. LDL levels decreased by only about 4% and biomarker levels rose slightly among those in the standard-approach arm. The researchers are now reviewing data from a three-year study of the HIVers to gauge the long-term effects of aggressive treatment.