HIV/AIDS

H/A: Hyperlipidemia (2009)

• Intervention
  What is the evidence regarding lifestyle interventions for the treatment of hyperlipidemia in people with HIV infection?

  • Conclusion

    12 studies were reviewed to evaluate lifestyle interventions for the treatment of hyperlipidemia in people with HIV infection. Two studies demonstrate that protease inhibitor therapy is associated with hyperlipidemia. Three studies report that other lifestyle factors are associated with hyperlipidemia, such as exercise and the consumption of fat, fiber and alcohol. Research on several lifestyle modification interventions for the treatment of hyperlipidemia in people with HIV infection reports improvements in serum lipid profile.   

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the evidence to support lifestyle interventions for the treatment of hyperlipidemia in people with HIV infection?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Barrios A, Blanco F, Garcia-Benayas T, Gomez-Viera JM, de la Cruz JJ, Soriano V, Gonzalez-Lahoz J. Effect of dietary intervention on highly active antiretroviral therapy-related dyslipemia. AIDS. 2002; 16(15): 2,079-2,081.
      • Gavrila A, Tsiodras S, Doweiko J, Nagy GS, Brodovicz K, Hsu W, Karchmer AW, Mantzoros CS. Exercise and vitamin E intake are independently associated with metabolic abnormalities in human immunodeficiency virus-positive subjects: A cross-sectional study. Clin Infect Dis. 2003; 36(12): 1,593-1,601. 
      • Gerber MT, Mondy KE, Yarasheski KE, Drechsler H, Claxton S, Stoneman J, DeMarco D, Powderly WG, Tebas P. Niacin in HIV-Infected individuals with hyperlipidemia receiving potent antiretroviral therapy. Clin Infect Dis. 2004; 39(3): 419-425. 
      • Hadigan C, Jeste S, Anderson EJ, Tsay R, Cyr H, Grinspoon S. Modifiable dietary habits and their relation to metabolic abnormalities in men and women with human immunodeficiency virus infection and fat redistribution. Clin Infect Dis. 2001; 33(5): 710-717. 
      • Melroe NH, Kopaczewski J, Henry K, Huebsch, J. Intervention for hyperlipidemia associated with protease inhibitors. J Assoc Nurses AIDS Care. 1999; 10: 55-69.
      • Moyle GJ, Lloyd M, Reynolds B, Baldwin C, Mandalia S, Gazzard BG. Dietary advice with or without pravastatin for the management of hypercholesterolemia associated with protease inhibitor therapy. AIDS. 2001; 15: 1,503-1,508.
      • Segarra-Newnham M. Hyperlipidemia in HIV-positive patients receiving antiretrovirals. Ann Pharmacother. 2002; 36: 592-595.
      • Shah M, Tierney K, Adams-Huet B, Boonyavarakul A, Jacob K, Quittner C, Dinges WL, Peterson D, Garg A. The role of diet, exercise and smoking in dyslipidemia in HIV-infected patients with lipodystrophy. HIV Medicine. 2005; 6: 291-298.
      • Thoni GJ, Fedou C, Brun JF, Fabre J, Renard E, Reynes J, Varray A, Mercier J. Reduction of fat accumulation and lipid disorders by individualized light aerobic training in human immunodeficiency virus infected patients with lipodystrophy and/or dyslipidemia. Diabetes Metab. 2002; 28: 397-404.
      • Wanke C, Gerrior J, Hendricks K, McNamara J, Schaefer E. Alterations in lipid profiles in HIV-infected patients treated with protease inhibitor therapy are not influenced by diet. Nutr Clin Pract. 2005; 20(6): 668-673.
      • Wohl DA, Tien HC, Busby M, Cunningham C, MacIntosh B, Napravnik S, Danan E, Donovan K, Hossenipour M, Simpson RJ. Randomized study of the safety and efficacy of fish oil (omega-3 fatty acid) supplementation with dietary and exercise counseling for the treatment of antiretroviral therapy-associated hypertriglyceridemia. Clinical Infectious Diseases. 2005; 41: 1498-1504.
      • Yarasheski KE, Tebas P, Stanerson B, Claxton S, Marin D, Bae K, Kennedy M, Tantisiriwat W, Powderly WG. Resistance exercise training reduces hypertriglyceridemia in HIV-infected men treated with antiviral therapy. J Appl Physiol. 2001; 90: 133-138.
  • Search Plan and Results: Treatment of Hyperlipidemia 2007