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Statin may affect markers associated with HIV progression
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Atorvastatin inhibited expression of cellular markers of immune activation and inflammation in patients with HIV infection, suggesting that the medication may be a promising candidate to interfere with HIV disease progression, according to a study published online.
Researchers led by Anuradha Ganesan, MD, of the National Naval Medical Center and the Uniformed Services University of the Health Sciences in Bethesda, Md., randomly assigned 22 patients with HIV who were not on antiretroviral therapy and who had cholesterol levels lower than those requiring statin therapy to either high-dose drug or placebo for 8 weeks. After a 4- to 6-week washout phase, each group was switched to the other treatment for another 8 weeks.
The researchers said HIV-1 RNA levels were not significantly affected by atorvastatin (Lipitor, Pfizer), but levels of such immune activation markers such as CD38 T cells (–3%; P=.03) and human leukocyte antigen-DR on CD4 (–2.5%; P=.02) and CD8 (–5%; P=.006) T cells were reduced.
“In vivo studies evaluating the effects of statins on HIV-1 RNA levels have yielded conflicting results. In a single nonrandomized study, HIV-infected participants exhibited a significant decline with lovastatin therapy. However, other prospective studies that evaluated pravastatin, simvastatin and atorvastatin failed to demonstrate an effect on HIV-1 RNA,” the researchers said in the study. “The ability to discern a difference in HIV-1 RNA level after treatment with a statin in these studies may have been limited by the small sample size, as well as the nonrandomized, open-label, and observational nature of most of these studies.”
The researchers said their findings with atorvastatin suggest that understanding the mechanism by which statins affect immune markers may identify new approaches for the management of HIV infection. However, their trial was not designed to demonstrate clinical benefits, for which larger studies of longer duration are needed.
In an accompanying editorial, Andrew Carr, MD, of St. Vincent’s Hospital in Sydney, Australia, said, “A very large study would probably be required to determine whether potentially positive effects of statin therapy on inflammatory biomarkers will translate into less HIV disease progression.”
For more information:
Carr A. J Infect Dis. 2011;doi:10.1093/infdis/jiq120.
Ganesan A. J Infect Dis. 2011;doi:10.1093/infdis/jiq115.
Disclosure: The researchers have no relevant financial disclosures.
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