Are HIV positive patients resistant to statin therapy?
<p>Abstract</p> <p>Background</p> <p>Patients with HIV are subject to development of HIV metabolic syndrome characterized by dyslipidemia, lipodystrophy and insulin resistance secondary to highly active antiretroviral therapy (HAART). Rosuvastatin is a highly potent HMG...
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| Format: | Article |
| Language: | English |
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BMC
2007-10-01
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| Series: | Lipids in Health and Disease |
| Online Access: | http://www.lipidworld.com/content/6/1/27 |
| _version_ | 1811280031185371136 |
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| author | Bennett Matthew T Johns Kevin W Bondy Gregory P |
| author_facet | Bennett Matthew T Johns Kevin W Bondy Gregory P |
| author_sort | Bennett Matthew T |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Patients with HIV are subject to development of HIV metabolic syndrome characterized by dyslipidemia, lipodystrophy and insulin resistance secondary to highly active antiretroviral therapy (HAART). Rosuvastatin is a highly potent HMG-CoA reductase inhibitor. Rosuvastatin is effective at lowering LDL and poses a low risk for drug-drug interaction as it does not share the same metabolic pathway as HAART drugs. This study sought to determine the efficacy of rosuvastatin on lipid parameters in HIV positive patients with HIV metabolic syndrome.</p> <p>Results</p> <p>Mean TC decreased from 6.54 to 4.89 mmol/L (25.0% reduction, p < 0.001). Mean LDL-C decreased from 3.39 to 2.24 mmol/L (30.8% reduction, p < 0.001). Mean HDL rose from 1.04 to 1.06 mmol/L (2.0% increase, p = ns). Mean triglycerides decreased from 5.26 to 3.68 mmol/L (30.1% reduction, p < 0.001). Secondary analysis examining the effectiveness of rosuvastatin monotherapy (n = 70) vs. rosuvastatin plus fenofibrate (n = 43) showed an improvement of 21.3% in TG and a decrease of 4.1% in HDL-C in the monotherapy group. The rosuvastatin plus fenofibrate showed a greater drop in triglycerides (45.3%, p < 0.001) and an increase in HDL of 7.6% (p = 0.08).</p> <p>Conclusion</p> <p>This study found that rosuvastatin is effective at improving potentially atherogenic lipid parameters in HIV-positive patients. The lipid changes we observed were of a smaller magnitude compared to non-HIV subjects. Our results are further supported by a small, pilot trial examining rosuvastatin effectiveness in HIV who reported similar median changes from baseline of -21.7% (TC), -22.4% (LDL-C), -30.1% (TG) with the exception of a 28.5% median increase in HDL. In light of the results revealed by this pilot study, clinicians may want to consider a possible resistance to statin therapy when treating patients with HIV metabolic syndrome.</p> |
| first_indexed | 2024-04-13T01:06:15Z |
| format | Article |
| id | doaj.art-1899697c44c340b683d974d597ee6261 |
| institution | Directory Open Access Journal |
| issn | 1476-511X |
| language | English |
| last_indexed | 2024-04-13T01:06:15Z |
| publishDate | 2007-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Lipids in Health and Disease |
| spelling | doaj.art-1899697c44c340b683d974d597ee62612022-12-22T03:09:18ZengBMCLipids in Health and Disease1476-511X2007-10-01612710.1186/1476-511X-6-27Are HIV positive patients resistant to statin therapy?Bennett Matthew TJohns Kevin WBondy Gregory P<p>Abstract</p> <p>Background</p> <p>Patients with HIV are subject to development of HIV metabolic syndrome characterized by dyslipidemia, lipodystrophy and insulin resistance secondary to highly active antiretroviral therapy (HAART). Rosuvastatin is a highly potent HMG-CoA reductase inhibitor. Rosuvastatin is effective at lowering LDL and poses a low risk for drug-drug interaction as it does not share the same metabolic pathway as HAART drugs. This study sought to determine the efficacy of rosuvastatin on lipid parameters in HIV positive patients with HIV metabolic syndrome.</p> <p>Results</p> <p>Mean TC decreased from 6.54 to 4.89 mmol/L (25.0% reduction, p < 0.001). Mean LDL-C decreased from 3.39 to 2.24 mmol/L (30.8% reduction, p < 0.001). Mean HDL rose from 1.04 to 1.06 mmol/L (2.0% increase, p = ns). Mean triglycerides decreased from 5.26 to 3.68 mmol/L (30.1% reduction, p < 0.001). Secondary analysis examining the effectiveness of rosuvastatin monotherapy (n = 70) vs. rosuvastatin plus fenofibrate (n = 43) showed an improvement of 21.3% in TG and a decrease of 4.1% in HDL-C in the monotherapy group. The rosuvastatin plus fenofibrate showed a greater drop in triglycerides (45.3%, p < 0.001) and an increase in HDL of 7.6% (p = 0.08).</p> <p>Conclusion</p> <p>This study found that rosuvastatin is effective at improving potentially atherogenic lipid parameters in HIV-positive patients. The lipid changes we observed were of a smaller magnitude compared to non-HIV subjects. Our results are further supported by a small, pilot trial examining rosuvastatin effectiveness in HIV who reported similar median changes from baseline of -21.7% (TC), -22.4% (LDL-C), -30.1% (TG) with the exception of a 28.5% median increase in HDL. In light of the results revealed by this pilot study, clinicians may want to consider a possible resistance to statin therapy when treating patients with HIV metabolic syndrome.</p>http://www.lipidworld.com/content/6/1/27 |
| spellingShingle | Bennett Matthew T Johns Kevin W Bondy Gregory P Are HIV positive patients resistant to statin therapy? Lipids in Health and Disease |
| title | Are HIV positive patients resistant to statin therapy? |
| title_full | Are HIV positive patients resistant to statin therapy? |
| title_fullStr | Are HIV positive patients resistant to statin therapy? |
| title_full_unstemmed | Are HIV positive patients resistant to statin therapy? |
| title_short | Are HIV positive patients resistant to statin therapy? |
| title_sort | are hiv positive patients resistant to statin therapy |
| url | http://www.lipidworld.com/content/6/1/27 |
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