Pravastatin helps cut cholesterol in HIV patients


WESTPORT, CT (Reuters Health) – Pravastatin is more
effective than dietary education alone in reducing total cholesterol in HIV-positive patients taking protease inhibitors, according to researchers at the Chelsea and Westminster Hospital, London, UK.

Dr. Graeme J. Moyle and colleagues note that acute elevations in cholesterol and triglycerides have been "clearly associated" with use of protease inhibitors. Dietary advice, they add, "has proven, albeit limited, benefits on plasma lipid levels."

To investigate the effectiveness of statin therapy in lowering such hypercholesterolemia, the researchers studied male HIV patients undergoing treatment with protease-inhibitor-based regimens. The findings appear in the August 17th issue of AIDS.

In this open-label trial, at baseline and at 12 weeks, all participants received advice on lowering cholesterol and triglycerides from a dietitian. In addition, 15 of the 30 assessable subjects were randomized to receive pravastatin 20 mg daily for 2 weeks and then 40 mg daily for the remainder of the 24-week treatment period.

At the end of the study, compared with baseline, there was a significant drop in total cholesterol in the pravastatin group (17.3%; p <0.05), but not in the advice-alone group (4%). Furthermore, the between-group differences "approached significance" (p < 0.051) at 24 weeks.

This, the researchers point out, "was accounted for entirely by a reduction in low density lipoprotein." The level fell by a calculated 19% in the pravastatin group and 5.5% in the advice-alone group.

No adverse events or loss of virological control was associated with pravastatin use.

Dr. Moyles' group concludes that this statin "may be safely and effectively" used to combat hypercholesterolemia in HIV patients receiving protease inhibitor therapy.

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