Evaluation and pharmacologic management of the HIV-infected patient with dyslipidemia

Dyslipidemia is common in persons living with HIV infection. Nurse clinicians must be able to recognize lipid abnormalities so that treatment plans can be developed. Managing dyslipidemia must be considered early in the HIV treatment process because certain antiretroviral therapy (ART) regimens, particularly those containing ritonavir, may exacerbate dyslipidemia risk. Statins are the most common medications used to treat dyslipidemia; however, because of drug-drug interactions, some are contraindicated with certain ART drugs. Other statins can be used but require dose adjustments when used with certain ART medications. Non-statin medications such as fibrates, niacin, and omega-3 fatty acid (fish oil) can be used to manage lipids and are discussed. Nurse clinicians should be prepared to discuss with the health care team potential alternative drug regimens for concurrent treatment of HIV infection and dyslipidemia.