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Titolo:
Treatment of hyperlipidemia in HIV-infected patients
Autore:
Geletko, SM; ZuWallack, AR;
Indirizzi:
Vet Affairs Med Ctr, Dept Pharm, Providence, RI 02908 USA Vet Affairs Med Ctr Providence RI USA 02908 arm, Providence, RI 02908 USA Univ Rhode Isl, Coll Pharm, Kingston, RI 02881 USA Univ Rhode Isl Kingston RI USA 02881 , Coll Pharm, Kingston, RI 02881 USA
Titolo Testata:
AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY
fascicolo: 7, volume: 58, anno: 2001,
pagine: 607 - 614
SICI:
1079-2082(20010401)58:7<607:TOHIHP>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
PROTEASE INHIBITORS; RISK FACTOR; HYPERTRIGLYCERIDEMIA; THERAPY; CHOLESTEROL; PREVENTION; MEN; EXERCISE; DISEASE; EVENTS;
Keywords:
antilipemic agents; antiretroviral agents; cholestyramine resin; colestipol; drug interactions; drugs; exercise; fibric acid derivatives; food; HIV infections; hyperlipidemia; hypertriglyceridemia; niacin; nutrition; toxicity;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
48
Recensione:
Indirizzi per estratti:
Indirizzo: Geletko, SM Vet Affairs Med Ctr, Dept Pharm, 830 Chalkstone Ave, Providence, RI 02908 USA Vet Affairs Med Ctr 830 Chalkstone Ave Providence RI USA 02908
Citazione:
S.M. Geletko e A.R. ZuWallack, "Treatment of hyperlipidemia in HIV-infected patients", AM J HEAL S, 58(7), 2001, pp. 607-614

Abstract

The treatment of hyperlipidemia in patients infected with HIV is discussed. Hyperlipidemia is common in HIV-infected patients receiving antiretroviraltherapy, especially protease inhibitors and stavudine. The recommendationsof the National Cholesterol Education Program (NCEP) may not entirely apply to HIV-infected patients. The pathogenesis of hyperlipidemia in these patients may make them refractory to traditional pharmacotherapy, and NCEP's emphasis on diet and exercise may be unrealistic. Other factors that may complicate treatment of hyperlipidemia include metabolism of many antiretroviral drugs by the cytochrome P-450 isoenzyme system, polypharmacy, and drug-food interactions. A patient's cardiac risk should first be assessed. Nonpharmacologic measures, such as a low-fat diet, weight reduction, and exercise, should be considered. Drug therapy is indicated for patients with familial combined hyperlipidemia that is associated with atherogenesis and for patients with triglyceride concentrations exceeding 1000 mg/dL. Drug therapy for hyperlipidemia involves niacin and statins, in addition to fibric acid derivatives and probucol. Switching among antiretroviral agents when one is found to cause hyperlipidemia should be done cautiously because of the riskfor viral rebound and disease progression. NCEP guidelines recommend monitoring iow-density-lipoprorein cholesterol levels four to six weeks after the start of lipid-lowering therapy and then at three months; more frequent monitoring may be necessary in HIV-infected patients. The treatment of hyperlipidemia in HIV-infected patients is complicated bytheir need for antiretroviral drugs, which can themselves contribute to lipid disorders.

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Documento generato il 19/01/20 alle ore 00:25:01