LOS ANGELES — HIV-positive patients on antiretroviral therapy who are prescribed lipid-lowering agents do not respond to those drugs as well as other patients do, according to a large retrospective study.
The HIV patients were 57% as likely to reach the National Cholesterol Education Program's Adult Treatment Panel III (ATP-III) lipid goals with treatment, compared with those not HIV infected, Michael Silverberg, Ph.D., of the division of research, Kaiser Permanente Northern California, Oakland, and his colleagues said in a poster presentation at the 14th Conference on Retroviruses and Opportunistic Infections.
The HIV patients also had a mean drop in total cholesterol that was 4 percentage points lower than the change in controls (a mean reduction of 18% vs. 22%), a drop in LDL cholesterol that was 2 percentage points lower (22% vs. 24%), and a drop in triglycerides that was 17 percentage points lower (36% vs. 53%). The researchers analyzed data from all the HIV patients in their health system seen between 1996 and 2005 who met the ATP-III definition of dyslipidemia, and compared them each with 10 controls, matched for age, sex, and first year of lipidemia, who also received lipid-lowering therapy.
HIV patients on a regimen of a protease inhibitor plus a nonnucleoside reverse transcriptase inhibitor had the lowest reductions in total cholesterol and triglycerides of any of the HIV patients. Their mean reduction in total cholesterol was 17%, and their mean reduction in triglycerides was 16%.
The most common lipid-lowering therapy used in the patients and the controls was a statin; pravastatin was used more commonly in the HIV patients, he said.