Statins Reduce T-Lymphocyte Activation in HIV

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Statins Reduce T-Lymphocyte Activation in HIV

February 23, 2011 (Bethesda, land) — High-dose atorvastatin (Lipitor, Pfizer) is associated with modest but statistically significant reductions in cellular markers of immune activation and inflammation in individuals with human immunodeficiency virus type 1 (HIV-1), according to the results of a small randomized, double-blind, placebo-controlled trial [1].

Investigators, led by Dr Anuradha Ganesan (National Naval Medical Center, Bethesda, MD), report that the short-term use of atorvastatin resulted in a significant reduction in the proportion of activated T lymphocytes, but treatment failed to significantly affect plasma HIV-1 RNA load. As the group notes, levels of T-lymphocyte activation are associated with a more rapid progression of HIV disease in adults not receiving treatment.

Previous studies examining the effects of statins on HIV-1 RNA levels have also yielded conflicting results, despite in vitro studies suggesting that statins might disrupt HIV-1 particle production, write the authors in the March 15, 2011 issue of the Journal of Infectious Diseases. In this study, the researchers randomized 22 HIV-1–infected individuals not receiving antiretroviral therapy to eight weeks of atorvastatin or to placebo. After a four- to six-week washout phase, the patients were switched to the other treatment assignments. All individuals had cholesterol levels below the threshold for statin therapy.

As reported, treatment did not alter HIV-1 RNA levels but did result in statistically significant reductions in some markers of immune activation, such as HLA-DR and CD38, on both CD4+ and CD8+ T lymphocytes. The reduction was in the order of 2.5% to 5.0%.

An accompanying editorial by Dr Carr (St 's Hospital, Sydney, Australia) points out that it is unknown whether the reduction in T lymphocytes is clinically significant [2]. Also, he writes that it is unlikely statins will suppress HIV replication, but it is possible the drugs could play a role in patients with persistent T-cell activation despite effective antiretroviral therapy. Larger studies are needed to determine whether the positive effect of statins on inflammatory biomarkers translates into "less HIV disease progression and fewer cases of inflammatory non–AIDS-related illnesses, such as cardiovascular disease and end-stage liver disease," he says.

The authors and editorialist report no conflicts of interest.

References

http://www.medscape.com/viewarticle/737861