A 55-year-old cisgender man with HIV returns to the clinic for management of severe hypertriglyceridemia. He has a CD4 count of 304 cells/mm³ and an undetectable HIV RNA level. He is taking dolutegravir and tenofovir alafenamide-emtricitabine. Six months ago, a fasting lipid panel showed triglycerides of 1,130 mg/dL, high-density lipoprotein (HDL) of 25 mg/dL, and low-density lipoprotein (LDL) was unable to be calculated. After receiving counseling from a nutritionist, he implemented a low-fat diet and increased his daily exercise. After 6 months, there was no improvement in the triglyceride levels. He does not have diabetes, liver disease, renal disease, or hypothyroidism. He is not taking any other medications, and he has a very low alcohol intake.