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With safety in mind, given the unknown impact of KD on patients with FH and the many potentially conflicting indirect data that may determine that impact, familial hypercholesterolaemia should be considered a relative contraindication to KD until these questions are resolved

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Whilst increased levels of needle and syringe distribution are welcome, high levels of secondary distribution may mean a large proportion of the IPED community are not accessing harm reduction, thereby impacting the provision of health services, including BBV testing