Some antiretrovirals can cause changes to the fats in your body which can lead to other health problems like diabetes or high cholesterol. A healthy diet can help to avoid these.
There are two types of cholesterol:
High density lipoprotein (HDL) carries cholesterol to the liver where it is either broken down or removed from the body as a waste product. HDL is known as ‘good cholesterol’ and it is good to have high levels.
Low-density lipoprotein (LDL) takes cholesterol to the cells. If they need it this is fine, but if not it can build up in the walls of the arteries. For this reason LDL is known as ‘bad cholesterol’.
Certain HIV drugs - like some protease inhibitors - can increase the levels of the bad cholesterol in your blood.
High cholesterol can cause narrowing of the arteries and lead to an increased risk of a heart attack or stroke and coronary heart disease. This is because cholesterol can line the arteries and make it difficult for blood to get to your heart and brain.
High cholesterol can also increase the risk of a blood clot.
Triglycerides are fats that can either come from your diet or be made by the liver.
Usually your triglyceride levels rise after you have eaten - especially after a fatty meal - but they usually return to normal.
For some people they stay elevated - this is more common in people who also have low rates of HDL (good) cholesterol. Too many triglycerides in the blood can cause heart problems.
You can lower your cholesterol through making changes to your lifestyle. These include:
Certain foods can lower (and raise) your cholesterol levels.
Your doctor may prescribe you statins - a medication to lower cholesterol - if lifestyle changes don’t make a difference.
There are two types of diabetes, Type 1 usually appears when you are a child – it cannot be prevented, it is a lifelong condition.
Type 2 diabetes is related to lifestyle factors, most commonly being overweight. Whatever your HIV status, being obese with a body mass index of 25 or above will increase your risk of Type 2 diabetes.
Ethnicity can also play a part – your chance of developing Type 2 diabetes increases fivefold if you are South Asian or Afro Caribbean. NHS Choices has some in-depth information about risk factors for Type 2 diabetes.
People living with HIV can have various risk factors for diabetes. These include:
Links have been found between Type 2 diabetes and some antiretroviral treatments. These include:
The good news is that Type 2 diabetes can be managed initially by lifestyle changes including:
Our Diabetes page has more detailed information about diabetes, lifestyle and antiretrovirals.
Fat redistribution - also known as lipodystrophy - used to be more common in people taking certain antiretrovirals.
It's characterised by gaining weight in some places and losing it in others, causing changes to the body's shape and appearance.
Lipodystrophy has been linked to the older antiretroviral drugs d4T and AZT.
These belong to the nucleoside reverse transcriptase inhibitor (NRTIs) class.
As these drugs are now largely avoided - and the antiretrovirals commonly prescribed today rarely cause body fat redistribution - lipodystrophy is now fairly uncommon in the UK.
Some experts also think there could be links to how long someone has had HIV, how damaged their immune system was when they started treatment and other factors such as age, gender and body mass index before starting treatment. However none of these have been proven to cause lipodystrophy.
People with lipodystrophy tend to lose weight from the:
and gain weight on the:
If people suffer from fat loss from their face, New Fill or Sculptra (polylactic acid fillers) can often help.
Polylactic acid injections into the face can stimulate the growth of collagen, which can plump out the sunken area.
If people have fat accumulation around the neck, this can be removed surgically, and so can lipomas – small growths of fat usually found on the limbs or trunk of the body.
People experiencing body fat changes often have metabolic problems which can lead to higher rates of fats (lipids) in the blood.
This can be in the form of raised cholesterol and triglycerides or diabetes. Changes to the diet and regular exercise can help to manage or avoid these conditions.
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Soft margarine is highly processed synthetic gunk and should not be consumed under any circumstances!
It is wholly unnatural and is not 'good' for you by any stretch of the imagination. Recommending corn and sunflower oil is equally as ridiculous.
Stick to unsalted grass fed butter, cold pressed olive oil and unrefined coconut oil. Many studies have shown that there is no evidence saturated fat is linked to cardio vascular disease.
This page is full of misinformation.
I thought that the latest research showed that butter isn't the problem it was once thought and that soft margarine was now considered bad because of the hydrogenation of fat involved. I see the commenter below also thinks this.
What does THT's medical Director say on the subject?
This article was last reviewed on
by Anna Peters
Date due for the next review: 12/1/2019
Content Author: Kerri Virani
Current Owner: Kerri Virani
Cholesterol - Introduction, NHS Choices, 27/8/15
Cholesterol - Treatment, NHS Choices, 27/8/15
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Various people talk about their experiences of living with HIV.
CAB - Citizens Advice Bureau
HIV Drug Interactions
George House Trust
Equality and Human Rights Commission
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