I am an internist at a tertiary care psychiatric hospital caring for a man with schizophrenia and longstanding AIDS. He is currently on Kaletra, Videx and Retrovir and his viral load is not detectable and his CD4 count has risen from 150 to over 400 on his current therapy.
The difficulty is that his psychosis is also refractory has he has receiving acute inpatient psychiatric care for the past 5 years.
His psychosis finally stabilized on a combination of 2 new generation atypical antipsychotics-Zyprexa and Risperdal- both of which along with his PI's can exacerbate his hyperlipidemia.
Have had no luck with Lopid-his triglycerides are still over 800.
Considering stopping the Lopid and starting lipitor but he would likely need high dose 80mg to see a significant change in his TG's.