Largest study compares cholesterol treatment in HIV patients and patients without HIV

Mar 02, 2009

A new study in the online issue of Annals of Internal Medicine has found that cholesterol medications can work well among certain HIV patients at risk for cardiovascular disease.

Though HIV patients are at higher risk for cardiovascular disease in part due to lipid abnormalities that can occur with the use of certain antiretroviral therapies, researchers now have evidence that cholesterol medications work very well in this population.

"This should be encouraging for patients and their providers," said the study's lead author Michael Silverberg, PhD, MPH, a research scientist with the Kaiser Permanente Division of Research in Oakland. CA. He explained that HIV Patients getting cholesterol-lowering treatments such as statins get slightly less benefit on cholesterol levels from the treatment as patients without HIV infection, but it is still a clinically significant benefit and side effects from the drugs occurred in very few patients.

In addition, say the researchers, the use of fibrates in combination with NNRTIs (a class of antiretroviral drugs) may be a good choice to manage triglyceride levels in HIV patients. Triglycerides are another fat in that blood that contributes to inflammation of the pancreas and may contribute to coronary disease, they explain.

The study, which appears in the March 3, 2009 online issue of the Annals of Internal Medicine, is the largest to date to compare the effectiveness and side effects of drugs to treat cholesterol problems in patients with and without HIV infection.

"The good news is lipid lowering therapy in HIV patients works, not quite as well as it does in patients without HIV, but close," explained Silverberg. Given the challenges for treating high cholesterol in HIV patients and the more aggressive target lipid goals for all patients, optimizing lifestyle factors like obesity and hypertension are also important factors to monitor for those with HIV infection, he added.

Researchers studied 829 patients with HIV infection and 6941 patients without HIV infection in the Kaiser Permanente health system that started cholesterol treatment during 1996 to 2005. The researchers compared changes in levels of low-density lipoprotein (LDL) cholesterol (bad cholesterol) and triglycerides (another fat in the blood) after the start of cholesterol treatment in patients with and without HIV infection. They also looked at liver and muscle-related side effects of cholesterol treatments and whether the cholesterol changes in patient with HIV infection were related to the types of HIV treatments patients were taking. Among patients taking statins, LDL levels declined only 3% less for HIV patients; however, among patients taking gemfibrozil, triglyceride levels declined 15% less for HIV patients. HIV patients taking both NNRTIs and gemfibrozil had identical triglyceride declines compared with those without HIV infection. Side effects of cholesterol treatments occurred in very few patients, but patients with HIV infection did have more changes in liver and muscle enzyme levels than patients without HIV infection.

Source: Kaiser Permanente

Explore further: HIV testing yields diagnoses in Kenya but few seek care

add to favorites email to friend print save as pdf

Related Stories

Navy wants to increase use of sonar-emitting buoys

1 hour ago

The U.S. Navy is seeking permits to expand sonar and other training exercises off the Pacific Coast, a proposal raising concerns from animal advocates who say that more sonar-emitting buoys would harm whales and other creatures ...

Uganda seizes massive ivory and pangolin haul

2 hours ago

Ugandan wildlife officers have seized a huge haul of elephant ivory and pangolin scales, representing the deaths of hundreds of endangered animals, police said Sunday.

Standalone wireless info display device an easy fit

8 hours ago

A Latvian team has come up with a good-looking WiFi display device, connecting to the Internet using WiFi, which runs on a high-capacity built-in battery and tracks what's important to you. This is a standalone ...

Recommended for you

HIV testing yields diagnoses in Kenya but few seek care

13 hours ago

Between December 2009 and February 2011, health workers with the AMPATH Consortium sought to test and counsel every adult resident in the Bunyala subcounty of Kenya for HIV. A study in the journal Lancet HIV reports that the campaign yielded more than 1,300 new positive diagnoses, but few of those new ...

The adaptability of pathogens

Jan 28, 2015

Drug-resistant HIV viruses can spread rapidly. This is the conclusion of a study conducted as part of the SWISS HIV Cohort Study, which is supported by the SNSF. Only the continuous introduction of new drugs can stop the ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.