Researchers in Ethiopia studied 450 adults with HIV who were taking a common HIV medication called dolutegravir. They found that about 74% of these patients had unhealthy cholesterol levels, which is higher than expected. Men were more likely to have this problem than women. The study suggests that people taking this HIV medication should have their cholesterol checked regularly so doctors can catch problems early and help prevent heart disease. This research helps doctors understand how HIV medications affect heart health.

The Quick Take

  • What they studied: Whether a popular HIV medication called dolutegravir causes unhealthy cholesterol levels in people taking it
  • Who participated: 450 adults with HIV in Ethiopia (58% women, 42% men) who had recently started HIV treatment
  • Key finding: About 3 out of 4 people on dolutegravir had unhealthy cholesterol levels, with men affected more often than women. People on this medication were about 5 times more likely to have cholesterol problems compared to other factors studied.
  • What it means for you: If you’re taking dolutegravir for HIV, ask your doctor to check your cholesterol regularly. This doesn’t mean you should stop taking the medication—HIV treatment is crucial—but monitoring helps catch problems early when they’re easier to treat.

The Research Details

Researchers collected information from 450 adults with HIV at health clinics in Hawassa, Ethiopia between January 2023 and May 2024. They used a method called systematic random sampling, which means they selected every few patients from a list to make sure the group was representative. They asked patients questions about their health and lifestyle, reviewed their medical records, and measured their cholesterol levels using standard medical guidelines. The researchers then used statistical analysis to figure out which factors were connected to unhealthy cholesterol levels.

This type of study is called a cross-sectional study, which means researchers looked at everyone at one point in time rather than following them over months or years. This approach is useful for finding patterns and connections, but it can’t prove that one thing directly causes another—only that they’re related.

Understanding how HIV medications affect cholesterol is important because high cholesterol increases the risk of heart disease and stroke. Since people with HIV are living longer thanks to effective medications, protecting their heart health becomes increasingly important. This study helps doctors know when to monitor cholesterol more carefully and when to consider additional treatments.

The study had a strong response rate of 96.8%, meaning almost all eligible participants completed it, which makes the results more reliable. The researchers used standard medical guidelines to measure cholesterol and used proper statistical methods. However, this was a snapshot study at one point in time in one region of Ethiopia, so results might differ in other places or populations. The study shows association (connection) but not necessarily cause-and-effect.

What the Results Show

The most striking finding was that 74% of participants had unhealthy cholesterol levels—much higher than in the general population. This breaks down to 79.8% of men and 69.8% of women. The most common cholesterol problem was low HDL cholesterol (the ‘good’ cholesterol), affecting about 2 out of 3 participants. High triglycerides and other cholesterol imbalances were each found in about 1 out of 3 people.

When researchers looked at what factors were connected to unhealthy cholesterol, they found three main ones: taking dolutegravir-based HIV medication, having a larger waist circumference, and having a larger neck circumference. People on dolutegravir were about 4.8 times more likely to have cholesterol problems. For every additional centimeter of waist circumference, the risk increased slightly. Similarly, each additional centimeter of neck circumference increased risk.

The connection between body measurements and cholesterol makes sense because fat stored around the middle and neck is linked to metabolic problems that affect cholesterol. The dolutegravir finding suggests the medication itself may influence how the body handles cholesterol.

The study found that unhealthy cholesterol was more common in men than women, which aligns with other research showing men tend to have more heart disease risk factors. The specific pattern of low HDL cholesterol being the most common problem is important because HDL is protective against heart disease, so low levels are particularly concerning.

Previous research on dolutegravir and cholesterol has shown mixed results—some studies found problems while others didn’t. This study adds to the evidence that there may be a real connection. The high overall rate of cholesterol problems (74%) is concerning and suggests that people with HIV on this medication need careful monitoring. The findings align with what doctors have observed about HIV medications sometimes affecting cholesterol, though the reasons aren’t completely understood.

This study only looked at people in one city in Ethiopia, so results might be different in other countries or populations. Because it was a snapshot study, researchers couldn’t prove that dolutegravir directly causes cholesterol problems—only that they’re connected. The study didn’t compare dolutegravir to other HIV medications directly, so we can’t say if this medication is worse than alternatives. Other factors that affect cholesterol (like diet and exercise) weren’t fully measured. Finally, the study didn’t follow people over time to see if cholesterol problems got worse or better.

The Bottom Line

People with HIV taking dolutegravir should have their cholesterol checked regularly—at least once a year, or more often if levels are abnormal. If cholesterol is high, doctors may recommend lifestyle changes like eating healthier foods, exercising more, and maintaining a healthy weight. Some patients may need cholesterol-lowering medications. These recommendations have moderate confidence because the study shows a strong connection but doesn’t prove the medication directly causes the problem.

This is most important for adults with HIV taking dolutegravir-based regimens. It’s also relevant for their doctors and healthcare providers. People with HIV taking other medications should discuss with their doctors whether similar monitoring is needed. This doesn’t apply to people without HIV or those not taking this medication.

Cholesterol problems can develop gradually over months to years. You might not feel any symptoms, which is why regular testing is important. If you start cholesterol-lowering treatments or lifestyle changes, it typically takes 4-12 weeks to see improvements in blood test results.

Want to Apply This Research?

  • Track cholesterol test results every 3-6 months, recording total cholesterol, HDL, LDL, and triglyceride levels. Also track waist circumference monthly as a simple indicator of metabolic health.
  • Set reminders for cholesterol screening appointments and log dietary choices (especially saturated fat intake) and weekly exercise minutes. Create alerts when it’s time for follow-up testing.
  • Create a dashboard showing cholesterol trends over time with target ranges highlighted. Set goals for waist circumference reduction and exercise frequency. Share results with healthcare provider through the app for better coordination of care.

This research describes patterns found in one study and should not replace medical advice from your healthcare provider. If you’re taking dolutegravir or any HIV medication, discuss these findings with your doctor before making any changes to your treatment. High cholesterol is manageable with proper monitoring and treatment. This study shows association, not proof of direct cause-and-effect. Always consult with your healthcare team about your individual risk factors and appropriate screening schedule.