Although it's too soon to recommend the drug for this purpose, the findings of this small study raise the possibility that "there might be drugs that can help adjust the immune response in HIV patients whether they're taking Aids medications or not," said Dr Brian Agan, director of HIV research with the Infectious Disease Clinical Research Program at the Uniformed Services University in Bethesda, Md. He works with some of the study's authors.
It's not unusual for HIV patients to take these cholesterol-lowering drugs, because the medications commonly used to combat HIV can cause cholesterol levels to skyrocket.
Scientists have wondered if statins' anti-inflammatory properties might have benefits for HIV patients besides reducing the risk of cardiovascular disease. In the new study, which was funded by the National Institutes of Health, researchers recruited 24 participants to randomly take either a high dose of Lipitor (atorvastatin) or a placebo.
HIV patients and statins: the study
The participants took their pills for eight weeks, stopped for several weeks, and then took the other kind of pills. The patients took no Aids medications, and their cholesterol levels weren't high enough to require taking statins. Neither group knew which pills they were taking.
The findings were recently published online in the Journal of Infectious Diseases. The drugs didn't affect levels of HIV in the 22 patients who remained in the study, but the medications did appear to curb their immune systems, reducing the inflammatory response.
Inflammation caused by the immune system is associated with HIV progression and death. "Persistent inflammation in patients with HIV, especially those on HIV treatment, has been associated with a worse clinical outcome. The cause of this inflammation remains unknown," said Andrew Carr, a professor of medicine at the University of New South Wales in Sydney, Australia, who wrote a commentary accompanying the study.
Is it feasible to give cholesterol-lowering drugs to HIV patients? They're definitely inexpensive, Agan said. And the side effects they cause may be mild and go away as time passes.
What comes next?
"For doctors, we should be studying the effects of statins over longer periods in patients with treated HIV disease whose virus is well-controlled but who still have excess inflammation to see if the anti-inflammatory effect of statins is still observed," said Carr. "If so, we would then need to determine if this anti-inflammatory effect improved health outcomes, which would require a long and very large study."
For now, both doctors said, physicians shouldn't change how they prescribe anti-cholesterol drugs.
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