title: Policosanol for managing human immunodeficiency virus-related dyslipidemia in a medically underserved population: a randomized, controlled clinical trial.
abstract: BACKGROUND
  Human immunodeficiency virus (HIV) infection is associated with dyslipidemia and increased risk for cardiovascular events; however, the use ofstatins in HIV-infected people is complicated by pharmacokinetic interactions and overlapping toxicities with antiretroviral medications. Policosanol is a dietary supplement derived from sugar cane that is widely used as a statin alternative in Latin America.
  
  
  OBJECTIVE
  To collect feasibility data on sugar cane-derived policosanol to normalize dyslipidemic profiles in a sample of medically underserved HIV-infected people.
  
  
  METHODS
  Randomized, controlled, double-blind clinical trial.
  
  
  METHODS
  Two infectious disease outpatient clinics located in a Health Resources Service Administration-designated medically underserved neighborhood in Chicago, Illinois.
  
  
  METHODS
  Fifty-four clinically stable HIV-infected people (91% black) with at least one lipid abnormality that warranted dietary modifications and/or drug therapy.
  
  
  METHODS
  Participants received either 20 mg/day of policosanol or placebo for 12 weeks, followed by a 4-week washout and crossover to the other arm.
  
  
  METHODS
  Efficacy measures included the standard lipid panel (low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides) and nuclear magnetic resonance (NMR)-derived lipoprotein particle profiles. Safety measures included CD4+ T lymphocyte counts, plasma HIV ribonucleic acid levels, serum creatinine, and liver function tests.
  
  
  RESULTS
  Policosanol supplementation was not associated with normalization of any dyslipidemic parameters as measured by the standard lipid panel or NMR spectroscopy-measured lipoprotein size or concentration. The supplement was well tolerated and was not associated with any changes in parameters of HIV disease progression.
  
  
  CONCLUSIONS
  Our findings corroborate recent studies conducted outside Cuba that have failed to find any lipid modulatory effects for policosanol.
authors: Rush University College of Nursing, Chicago, Illinois, USA. Barbara_a_swanson@rush.edu
authors: Barbara
authors: B
authors: Swanson
authors: Joyce K
authors: JK
authors: Keithley
authors: Beverly E
authors: BE
authors: Sha
authors: Louis
authors: L
authors: Fogg
authors: Judith
authors: J
authors: Nerad
authors: Richard M
authors: RM
authors: Novak
authors: Oluwatoyin
authors: O
authors: Adeyemi
authors: Gregory T
authors: GT
authors: Spear
mesh_terms: D000328:Adult; D000924:Anticholesteremic Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D018592:Cross-Over Studies; D004311:Double-Blind Method; D050171:Dyslipidemias / Q000139:chemically induced / Q000188:drug therapy*; D005233:Fatty Alcohols / Q000008:administration & dosage*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D012720:Severity of Illness Index; D017211:Treatment Failure; D014280:Triglycerides / Q000097:blood
chemical_list: D000924:Anticholesteremic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D005233:Fatty Alcohols; D014280:Triglycerides; C080710:policosanol