Official website of the Johns Hopkins Antibiotic (ABX), HIV, Diabetes, and Psychiatry Guides, powered by Unbound Medicine. Johns Hopkins Guide App for iOS, iPhone, iPad, and Android included. Explore these free sample topics:
-- The first section of this topic is shown below --
- Uncontrolled HIV is associated with increased cardiovascular (CV) risk and acute MI.
- Lipid effects associated with ART
- PIs: all boosted PIs → ↑LDL, ↑TG, ↑HDL. ATV/r and DRV/r preferred over FPV/r and LPV/r.
- NRTIs: d4T > ZDV > ABC→ ↑LDL and ↑TG. TDF has lipid-lowering effect. ABC associated with MI in D:A:D and some other observational studies, but other studies have not found an association. DHHS and IAS-USA guidelines recommend avoiding ABC in patients with high CV risk.
- NNRTIs: EFV → ↑TG, ↑LDL, ↑HDL.
- INSTIs: EVG/COBI/TDF/FTC → ↑TG, ↑LDL, ↑HDL. DTG > RAL → ↑TG
- Drug interactions with PIs and COBI preclude use of some statins; others should be initiated at low doses with monitoring for statin side effects. (See Pharmacological Therapy)