Protease inhibitors help prevent the human immunodeficiency virus from replicating in your body. The use of protease inhibitors has decreased the number of people who developed AIDS or died from the virus by 70 percent, according to 2006 information from the Aids Treatment Data Network. However, protease inhibitors can also cause a rise in cholesterol and triglyceride levels, along with the development of lipodystrophy, abnormal fat distribution patterns with decreased fat in the legs, face, arms and buttocks and increased fat deposits in the stomach, neck, upper back or breasts.
Risk
It is estimated than 50 percent of people taking protease inhibitors for two years develop high cholesterol levels, according to a 2002 article in the "American Journal of Cardiovascular Drugs." Researchers also note that the risk increases the longer you remain on protease inhibitor therapy.
Prescription Drugs
If you have HIV and high cholesterol levels, your doctor may prescribe statins, medications that interfere with your liver's ability to make cholesterol and fall into the classification of hydroxymethylglutaryl coenzyme A, or HMG-CoA reductase inhibitors. The 2002 article in the "American Journal of Cardiovascular Drugs" notes that certain drugs in this class may work better than others when you take protease inhibitors; simvastatin and lovastatin should not be used. Pravastatin has benefits that outweigh the risks of use, while atorvastatin may increase the risk of rhabdomyolysis, a complication of statin use characterized by skeletal muscle and liver toxicity, according to a report in the May 2002 issue of "Expert Opinion on Drug Safety." Protease inhibitors may interfere with the actions of fibrates, another type of cholesterol-lowering medication.
Lifestyle Changes
Lifestyle modifications such as exercising, not smoking and decreasing saturated fat intake can also help lower cholesterol levels. Taking fish oil may lower triglycerides by 25 percent, but may also raise low-density lipoprotein, the so-called "bad" cholesterol, by 20 percent, David Wohl, M.D. of the University of North Carolina-Chapel Hill states. Drinking alcohol can also raise triglyceride levels, so cutting down or cutting out alcohol may help.
Complications
Very high cholesterol levels can increase your risk of developing atherosclerosis -- plaque buildup inside blood vessel walls that can increase your risk of heart problems such as stroke, high blood pressure or heart attack. Pancreatitis, or inflammation of the pancreas, can also occur. Your doctor may suggest changing medications, since some drugs have more of a cholesterol-raising effect than others; Invirase raises cholesterol levels less than most other protease inhibitors and Reyataz barely raises cholesterol at all, according to Dr. Wohl.
References
- "American Journal of Cardiovascular Drugs"; Management of protease Inhibitor-Associated Hyperlipidemia; S. Penzac, et al.; 2002
- Aids Treatment Data Network; What Are Protease Inhibitors?; August 2006
- "Expert Opinion on Drug Safety"; Risk-Benefit of HMG-CoA Reductase Inhibitors in the Treatment of HIV Protease Inhibitor-Related Hyperlipidaemia; S. Chuck, et al.; May 2002
- Body Health Resources Foundation; Cholesterol and Triglyceride Problems; December 2005
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