title: Statins Blunt HAART-Induced CD4 T-Cell Gains but Have No Long-Term Effect on Virologic Response to HAART.
abstract: BACKGROUND
  Statins are increasingly used in HIV-infected patients, but the effect of their immunomodulatory properties on antiretroviral-induced immune reconstitution is unknown.
  
  
  METHODS
  The authors compared 6-month and 1-year changes in CD4 T-cell count, plasma HIV ribonucleic acid (RNA), and serum lipids in 69 HIV-infected patients receiving statins and 127 controls matched by age, nadir CD4 T-cell count, and hepatitis C serostatus. All patients were receiving highly active antiretroviral therapy (HAART). The authors used standard statistical tests for univariate comparisons and estimated average change in outcome measurements through repeated measures general linear models.
  
  
  RESULTS
  Patients receiving statins had significantly higher median CD4 T-cell counts (430 vs 225 cells/microL, P < .001) and lower HIV RNA levels (2.3 vs 2.9 log10 copies/mL, P < .001) than controls. Statin-treated patients had diminished CD4 T-cell gain at 6 months, but this difference was not statistically significant at 12 months, despite similar 12-month virologic success rates. Patients receiving statins gained, on average, an estimated 60 fewer CD4 T-cells in the first 6 months than controls.
  
  
  CONCLUSIONS
  Exposure to statins was associated with decreased CD4 T-cell gains during HAART in a cohort of HIV-infected patients, despite adequate virologic response. Studies with longer follow-up and detailed metabolic and immunologic monitoring are needed to confirm these findings and assess their significance and mechanisms.
authors.affiliation: University Hospitals of Cleveland and Case Western Reserve University Center for AIDS Research, Cleveland, OH 44106-5083, USA. rodriguez.benigno@clevelandactu.org
authors.forename: Benigno
authors.initials: B
authors.lastname: Rodriguez
authors.forename: Hernan
authors.initials: H
authors.lastname: Valdez
authors.forename: Anne
authors.initials: A
authors.lastname: Mijch
authors.forename: Kerrie
authors.initials: K
authors.lastname: Watson
authors.forename: Michael M
authors.initials: MM
authors.lastname: Lederman
authors.forename: Grace A
authors.initials: GA
authors.lastname: McComsey
authors.forename: Chariclia V
authors.initials: CV
authors.lastname: Loupa
authors.forename: Ian
authors.initials: I
authors.lastname: Woolley
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans; D013995:Time; D019562:Viral Load