title: Changes in oxidized lipids drive the improvement in monocyte activation and vascular disease after statin therapy in HIV.
abstract: BACKGROUND
  Oxidative stress plays a significant role in atherosclerosis development. HIV infection has been linked with heightened cardiovascular disease risk. HMG-CoA reductase inhibitors may reduce oxidative stress and subsequently subclinical vascular disease in HIV.
  
  
  METHODS
  This is a randomized, placebo-controlled trial to evaluate the effect of rosuvastatin in HIV-infected adults on stable antiretroviral therapy with low-density lipoprotein less than 130  mg/dl and increased inflammation or T-cell activation on subclinical vascular disease. Changes over 48 weeks in oxidative stress markers, oxidized low-density lipoprotein (oxLDL) and F2-isoprostane/creatinine ratio (F2-IsoP/Cr), were compared between groups. Spearman correlation and multivariable linear regression were used to evaluate relationships between changes in markers of oxidative stress, inflammation and monocyte activation and carotid intima media thickness (CIMT).
  
  
  RESULTS
  One hundred and forty-seven adults enrolled (72 to rosuvastatin and 75 to placebo). In the rosuvastatin group, oxLDL decreased significantly over 24 weeks compared to placebo [mean absolute change in log-oxLDL for rosuvastatin -0.2  ±  0.468 log U/l (P < 0.001 within-group) vs. placebo -0.018  ±  0.456 log U/l (P = 0.83 within-group); P = 0.004 between groups] and this change was linked with changes in soluble CD14 and proportion of patrolling monocytes (CD14dimCD16). Although oxLDL levels increased after initially declining and were not different from placebo at week 48, the early improvement in oxLDL was associated with improved CIMT at week 48. Changes in F2-IsoP/Cr were not significant between groups.
  
  
  CONCLUSIONS
  Rosuvastatin decreases oxLDL levels early after initiation and is associated with decreased monocyte activation. Early improvement in oxLDL is linked with improved CIMT in treated HIV infection.
authors.affiliation: aMetroHealth Medical CenterbCase Western Reserve University School of Medicine, Cleveland, OhiocWilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MarylanddOhio State University School of Health and Rehabilitation Sciences, Division of Medical Laboratory Science, ColumbuseUniversity Hospitals Case Medical Center, Cleveland, Ohio, USA.
authors.forename: Corrilynn O
authors.initials: CO
authors.lastname: Hileman
authors.forename: Randi
authors.initials: R
authors.lastname: Turner
authors.forename: Nicholas T
authors.initials: NT
authors.lastname: Funderburg
authors.forename: Richard D
authors.initials: RD
authors.lastname: Semba
authors.forename: Grace A
authors.initials: GA
authors.lastname: McComsey
mesh_terms: D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000008:administration & dosage*; D059168:Carotid Intima-Media Thickness; D003404:Creatinine / Q000097:blood; D028441:F2-Isoprostanes / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology*; D010919:Placebos / Q000008:administration & dosage; D000068718:Rosuvastatin Calcium / Q000008:administration & dosage*; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000473:pathology / Q000517:prevention & control*
chemical_list: D000924:Anticholesteremic Agents; D028441:F2-Isoprostanes; D008077:Lipoproteins, LDL; D010919:Placebos; C099252:oxidized low density lipoprotein; D000068718:Rosuvastatin Calcium; D003404:Creatinine