Concerns regarding adverse cardiac effects of antiretroviral therapy have recently emerged. Protease inhibitors have been associated with an increased risk of myocardial infarction that is partially due to dyslipidaemia. Ritonavir-boosted atazanavir is commonly used as part of combination treatment in IDUs because of its modest effect on lipid levels and also due to the simplicity of once daily dosing. However, it has other associated risk factors and intolerability due to hyperbilirubinaemia is also an issue.