9th Annual Conference Of The British HIV Association [BHIVA]


24 – 26 April 2003, University of Manchester
Institute of Science & Technology (UMIST)
Manchester


[TITLE:] ATORVASTATIN AND PRAVASTATIN FOR HYPERCHOLESTEROLAEMIA IN HIV-POSITIVE PATIENTS RECEIVING HAART

[AUTHOR(S):] NP Smith, MR Nelson, GJ Moyle and BG Gazzard
Chelsea and Westminster Hospital, London, UK

BHIVA Conf 2003 Apr 24-26;9:O22

AIM: To study the effect of atorvastatin (A) and pravastatin (P) in reducing serum cholesterol in HIV-positive patients receiving highly active antiretroviral therapy (HAART).

METHODS: A retrospective case-note review of patients attending the unit who had received 4 or more weeks of either A or P for hypercholesterolaemia associated with HAART. Mean serum cholesterol before and after starting or changing dose of therapy was recorded along with the number of patients whose cholesterol decreased to within normal parameters (3.5–6.5 mmol/l). The duration of therapy, demographic details and antiretroviral therapy were also recorded.

RESULTS: 102 patients received A with 125 treatment episodes and 77 patients received P with 91 treatment episodes. Both groups were similar at baseline with respect to age, sex and risk category. In 56% of patients receiving A, cholesterol decreased to <6.6 mmol/l compared with 32% of patients receiving P (0.01<P<0.02, 95% confidence interval 0.141–0.339). Results are summarised below.

Mean pre- Mean post- % with choles-
Treatment Mean treatment treatment terol decrease
episodes dose cholesterol cholesterol <6.6 mmol/l
A 125 12.4 mg 7.8 mmol/l 6.4 mmol/l 56%
P 91 31.6 mg 8.2 mmol/l 6.8 mmol/l 32%

CONCLUSIONS: Both A and P decrease serum cholesterol in HIV-positive patients receiving HAART. Patients receiving A were significantly more likely to have a decrease in cholesterol to <6.6 mmol/l compared with those receiving P. We recommend that A be considered as first-line ahead of P for the treatment of hypercholesterolaemia in HIV-positive patients receiving HAART. There was no clear difference in the effect on protease inhibitor (PI)-containing regimens compared with non-PI regimens between treatment groups.

PRESENTING AUTHOR: NP Smith

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