Statin therapy decreases serum levels of high-sensitivity C-reactive protein and tumor necrosis factor-α in HIV-infected patients treated with ritonavir-boosted protease inhibitors.

Abstract

BACKGROUND:

Statins are lipid-lowering drugs that exhibit anti-inflammatory and immune-modulatory properties, leading to a reduction of serum levels of C-reactive protein (CRP) in the general population.

OBJECTIVE:

Because very limited data are available today, our objective was to assess the lipid-lowering effects of statins and their capacity to decrease selected soluble markers of inflammation in HIV-infected patients.

METHODS:

Retrospective cohort study of HIV-infected adult patients with hypercholesterolemia who were receiving a stable antiretroviral regimen including a ritonavir-boosted protease inhibitor and who started a lipid-lowering therapy with rosuvastatin (10 mg daily), atorvastatin (10 mg daily), or pravastatin (40 mg daily) and were followed-up for at least 12 months. One hundred and fifty-one patients were enrolled in the study: 51 in the rosuvastatin group, 47 in the atorvastatin group, and 53 in the pravastatin group. The primary observation was change in plasma lipid levels and serum markers of inflammation (high-sensitivity C-reactive protein [hsCRP], interleukin-6 [IL-6], and tumor necrosis factor-α [TNF- α]), while secondary observations include immunovirological parameters and safety profile of statins.

RESULTS:

One year after starting the statin therapy, patients treated with rosuvastatin had significantly greater decreases in total cholesterol and LDL cholesterol than subjects on atorvastatin or pravastatin. All statins led to a similar, significant reduction in serum levels of hsCRP and TNF-α, without correlation between biomarkers and lipid values, and toxicity rates were similar for all 3 statins.

CONCLUSION:

Our findings suggest that rosuvastatin has a significantly greater lipid-lowering effect than atorvastatin or pravastatin, but all 3 statins exert a similar effect in lowering markers of inflammation as hsCRP and TNF-α.

• Authors: Leonardo Calza, Filippo Trapani, Michele Bartoletti, Roberto Manfredi, Vincenzo Colangeli, Marco Borderi, Gabriele Grossi, Roberto Motta, Pierluigi Viale
• Journal: HIV clinical trials (HIV Clin Trials) 2012 May-Jun Vol. 13 Issue 3 Pg. 153-61 ISSN: 1528-4336 [Print] England
• PMID: 22592095 (Publication Type: Journal Article)

Chemical References

• Anti-Inflammatory Agents
• Cholesterol, HDL
• Cholesterol, LDL
• HIV Protease Inhibitors
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Tumor Necrosis Factor-alpha
• C-Reactive Protein
• Ritonavir

Topics

• Acquired Immunodeficiency Syndrome (blood, drug therapy)
• Adult
• Anti-Inflammatory Agents (pharmacology)
• C-Reactive Protein (analysis)
• Cholesterol, HDL (blood)
• Cholesterol, LDL (blood)
• Cohort Studies
• Female
• HIV Protease Inhibitors (therapeutic use)
• HIV-1
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (adverse effects, pharmacology)
• Male
• Middle Aged
• Retrospective Studies
• Ritonavir (therapeutic use)
• Tumor Necrosis Factor-alpha (blood)