Anti retroviral drugs of class protease inhibitors drugs and increased blood cholesterol level.

Antiretroviral drugs belonging to class protease inhibitors are known to cause increase in cholesterol level in patients taking protease inhibitors drugs. Anti retroviral protease inhibitors drugs which act by inhibiting enzyme protease , this enzyme helps HIV virus in building its protein by breaking higher proteins in to smaller on, and then make use of these smaller one for building HIV and viral envelop and thus help in reproduction of HIV virus.

Every drug do not specifically act on a particular system, but they do have some varied degree of action on other metabolic and biochemical systems and cycles, antiretroviral drug belonging to category protease inhibitors cause increase in cholesterol, in a broader term this class of drug may cause hypertriglyceridemia, hypercholesterolemia and the increased cholesterol level in patients and subject them to high risk of developing atherosclerosis, by increasing the level atherogenic lipoproteins and endothelial dysfunction which increase the risk of atherosclerosis and heart disease.

Drug Norvir, is known to cause more hyperlipidemia compared to other protease inhibitor drugs . Also a non protease drug Sustiva is also known to increase blood lipid levels. Other underlying factors like smoking , alcohol consumption , and low physical activity , which affect lipid metabolism and are responsible for increased blood cholesterol level must be considered , there is great risk of developing hyperlipidemia with those underlying factors.Patient are advised to quite smoking and do some physical exercise regularly, must avoid alcohol.

What is done when a patient develop hyperlipidemia :
Hyperlipidemia associated with protease inhibitors is a reversible type which means it ceases if changes are made in antiretroviral drugs to treat hyperlipidemia, doctor decide up on consideration of the risk of hyperlipidemia compared to viral count and patients health, hyperlipidemia is also managed with exercise and altering the food to low fat diet.

Incase of sever conditions following drugs which lower blood cholesterol are given
Statins : Lipitor (atorvastatin) and Pravachol (pravastatin).
Fibrates: Lopid (gemfibrozil) and Tricor (fenofibrate)

All above drugs have serious side effects in high dose and long term , for example, drug belonging to group statins are known to cause rhabdomyolysis and drug belonging to group Fibrates are known to increase risk of developing gall stone.

Source:

http://www.jci.org/articles/view/16261#B5

http://www.aidsinfo.nih.gov/contentfiles/Hyperlipidemia_FS_en.pdf

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Authored by :  B V Waghmare

Last updated: 06-Sep-2011