BACKGROUND: Both HIV and its treatment, particularly protease inhibitors, can cause lipidemia similar to that seen with the metabolic syndrome. The most notable effects are elevated triglyceride levels and decreased high-density lipoprotein cholesterol levels, with or without elevated low-density lipoprotein cholesterol (LDL-C) levels.

OBSERVATION: Current recommendations by the National Cholesterol Education Program for HIV-infected persons focus on LDL-C as the primary target of therapy: after lifestyle modifications, statins should be used to lower LDL-C levels.

CONCLUSION: Therapy with fibrates is recommended to lower triglyceride levels. However, omega-3 fatty acids can be an effective means of lowering triglyceride levels as well, particularly in patients with markedly elevated triglyceride levels.