Comparative Effectiveness and Toxicity of Statins Among HIV-Infected Patients

Abstract

our findings suggest that atorvastatin and rosuvastatin are preferable to pravastatin for treatment of HIV-infected patients with dyslipidemia, due to greater declines in total cholesterol, LDL-C, and non-HDL-C, with similar lower toxicity rates.

Alcoholic Extract of Lotus Leaves Improves Lipid Profile in Rats with HIV Protease Inhibitor-induced Dyslipidemia

“…Therefore, lipid-lowering agents are required to be more carefully administered to patients on HAART compared with the general population (36). Although a few lipid-lowering drugs such as gemfibrozil, atorvastatin or rosuvastatin are relatively safe and potent for treatment of HIV-infected patients with dyslipidaemia (40,41), they are relatively expensive for most patients in developing countries, especially those from rural areas. All of these suggest that further efforts are needed to develop effective, safe and inexpensive alternatives for HIV/ AIDS patients with dyslipidaemia.…”

Use of HMG-CoA Reductase Inhibitors in the HIV Population: Implications for Individualized Treatment Selection

“…The likelihood of reaching NCEP goals for LDL-C levels is higher with the use of rosuvastatin (odds ratio [OR], 2.1; P = 0.03) and atorvastatin (OR, 2.1; P = 0.001) compared with pravastatin. 34 In another trial, patients taking atorvastatin or rosuvastatin had a greater reduction in triglycerides (26.8% and 26.1%, respectively) than those taking simvastatin or pravastatin (14.8% and 13.2%, respectively) for the 40 mg dose of each drug. 49 A recent study reports superior reduction in LDL-C with pitavastatin 4 mg daily compared with pravastatin 40 mg daily (31.1% vs. 20.9%, respectively, P < 0.001) in HIV-infected adults.…”

“…The primary outcome measured was the change in lipid levels during statin therapy after 12 months. 34 The median follow-up time was 19 months. TC was lowered by 39 (95% CI = 31-48) mg/dL in the atorvastatin group, 25 (95% CI = 16-34) mg/dL in the pravastatin group, and 43 (95% CI = 31-55) mg/dL in the rosuvastatin group.…”

Clinical Management Considerations for Dyslipidemia in HIV–Infected Individuals

“…44 After 1 year of statin therapy, decreases in TC and LDL-C were significantly greater in patients receiving atorvastatin and rosuvastatin (odds ratio [OR] for both, 2.1), compared with pravastatin. The likelihood of reaching NCEP goals for non-HDL-C levels was higher for rosuvastatin (OR, 2.3), but not for atorvastatin (OR, 1.5), compared with pravastatin.…”

“…Toxicity rates were similar for all 3 drugs. 44 Although pravastatin has been most commonly used in HIV-infected patients because of safety reasons, these data suggest that rosuvastatin or atorvastatin are more effective.…”