Safety and efficacy of HMG-CoA reductase inhibitors for treatment of hyperlipidemia in patients with HIV infection.
OBJECTIVE
To assess the efficacy and safety of HMG-CoA reductase inhibitors (statins) in patients with human immunodeficiency virus (HIV) infection and hyperlipidemia.


METHODS
Retrospective analysis.


METHODS
HIV clinic.


METHODS
Twenty-six HIV-infected patients with hyperlipidemia.


METHODS
Five patients received pravastatin, 13 lovastatin, 10 simvastatin, and 2 atorvastatin (total 30 courses).


RESULTS
Reductions in cholesterol and triglycetides were used to assess efficacy; creatine kinase (CK), liver enzymes, and myalgia were markers of statin toxicity. After a median of 8.2 and 7.2 months of treatment, the agents collectively reduced median baseline total cholesterol 27% (354 to 263 mg/dl) and triglycerides 15% (513 to 438 mg/dl), respectively. Two patients, one with marked CK elevations, experienced myalgias with lovastatin, and two experienced transaminase elevations 3 or more times the upper limit of normal.


CONCLUSIONS
Statins are effective in reducing total cholesterol and triglycerides in HIV-infected patients, although lipid levels infrequently return to normal. Lovastatin should be avoided in patients receiving concomitant drugs that may potentiate skeletal muscle toxicity with this agent.
Penzak
S R
SR
Department of Pharmacy Practice, Mercer University, Southern School of Pharmacy, Atlanta, Georgia 30341-4155, USA.
Chuck
S K
SK
Stajich
G V
GV
D000328:Adult; D000368:Aged; D002784:Cholesterol / Q000097:blood*; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000187:drug effects / Q000378:metabolism; D012189:Retrospective Studies; D000637:Transaminases / Q000187:drug effects / Q000378:metabolism; D014280:Triglycerides / Q000097:blood*
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014280:Triglycerides; D002784:Cholesterol; D000637:Transaminases