title: Statin therapy decreases serum levels of high-sensitivity C-reactive protein and tumor necrosis factor-α in HIV-infected patients treated with ritonavir-boosted protease inhibitors.
abstract: BACKGROUND
  Statins are lipid-lowering drugs that exhibit anti-inflammatory and immune-modulatory properties, leading to a reduction of serum levels of C-reactive protein (CRP) in the general population.
  
  
  OBJECTIVE
  Because very limited data are available today, our objective was to assess the lipid-lowering effects of statins and their capacity to decrease selected soluble markers of inflammation in HIV-infected patients.
  
  
  METHODS
  Retrospective cohort study of HIV-infected adult patients with hypercholesterolemia who were receiving a stable antiretroviral regimen including a ritonavir-boosted protease inhibitor and who started a lipid-lowering therapy with rosuvastatin (10 mg daily), atorvastatin (10 mg daily), or pravastatin (40 mg daily) and were followed-up for at least 12 months. One hundred and fifty-one patients were enrolled in the study: 51 in the rosuvastatin group, 47 in the atorvastatin group, and 53 in the pravastatin group. The primary observation was change in plasma lipid levels and serum markers of inflammation (high-sensitivity C-reactive protein [hsCRP], interleukin-6 [IL-6], and tumor necrosis factor-α [TNF- α]), while secondary observations include immunovirological parameters and safety profile of statins.
  
  
  RESULTS
  One year after starting the statin therapy, patients treated with rosuvastatin had significantly greater decreases in total cholesterol and LDL cholesterol than subjects on atorvastatin or pravastatin. All statins led to a similar, significant reduction in serum levels of hsCRP and TNF-α, without correlation between biomarkers and lipid values, and toxicity rates were similar for all 3 statins.
  
  
  CONCLUSIONS
  Our findings suggest that rosuvastatin has a significantly greater lipid-lowering effect than atorvastatin or pravastatin, but all 3 statins exert a similar effect in lowering markers of inflammation as hsCRP and TNF-α.
authors.affiliation: Department of Internal Medicine, Geriatrics and Nephrologic Diseases, Section of Infectious Diseases, Alma Mater Studiorum University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy. leonardo.calza@unibo.it
authors.forename: Leonardo
authors.initials: L
authors.lastname: Calza
authors.forename: Filippo
authors.initials: F
authors.lastname: Trapani
authors.forename: Michele
authors.initials: M
authors.lastname: Bartoletti
authors.forename: Roberto
authors.initials: R
authors.lastname: Manfredi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Colangeli
authors.forename: Marco
authors.initials: M
authors.lastname: Borderi
authors.forename: Gabriele
authors.initials: G
authors.lastname: Grossi
authors.forename: Roberto
authors.initials: R
authors.lastname: Motta
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Viale
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000188:drug therapy*; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000494:pharmacology*; D002097:C-Reactive Protein / Q000032:analysis*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D005260:Female; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D015497:HIV-1; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019438:Ritonavir / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D000893:Anti-Inflammatory Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D017320:HIV Protease Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D019438:Ritonavir