Lipodystrophy Guidelines Favor Changes in Lifestyle

New guidelines from the HIV Medicine Association of the Infectious Disease Society of America and the Adult AIDS Clinical Trials Group favor lifestyle changes, such as low-fat diets, stopping smoking, and exercise, as the first-line treatment of high cholesterol and triglyceride levels in HIV patients. The guidelines, first published in the September 1 edition of Clinical Infectious Diseases, say that because there is the potential for adverse interactions between lipid-lowering medications and antiretroviral drugs, lifestyle changes should be tried first in nearly all HIV patients. Medications should be first-line therapy, the guidelines say, only for people already exhibiting signs of coronary heart disease or who have low-density lipoprotein, or 'bad,' cholesterol levels above 220. The guidelines also include drug recommendations for HIV-positive adults who do not achieve lower cholesterol and triglyceride levels through lifestyle changes, but they warn that HIV patients taking Rescriptor or protease inhibitors should not take Zocor or Mevacor/Altocor because of adverse drug interactions. Lipitor also should be used with caution in these patients, according to the guidelines.