LOS ANGELES — HIV-positive patients on antiretroviral therapy who are prescribed lipid-lowering agents do not respond to those drugs as well as other patients do, according to a large retrospective study by Kaiser Permanente.
The HIV patients were only 57% as likely to reach the National Cholesterol Education Program's Adult Treatment Panel III (ATP-III) lipid goals with treatment, compared with patients not HIV infected, Michael Silverberg, Ph.D., and his colleagues said in a poster presentation at the 14th Conference on Retroviruses and Opportunistic Infections.
The HIV patients also had a mean drop in total cholesterol that was lower than the change in controls (18% vs. 22%), as well as lower drops in LDL cholesterol (22% vs. 24%) and in triglycerides (36% vs. 53%).
Few previous studies have investigated the response of HIV patients on antiretroviral therapy to lipid-lowering treatment, said Dr. Silverberg of the division of research, Kaiser Permanente Northern California, Oakland. Their investigation analyzed data from all the HIV patients in their health system seen between 1996 and 2005 who met the ATP-III definition of dyslipidemia, and compared them each with 10 controls, matched for age, sex, and first year of lipidemia, who also received lipid-lowering therapy.
The study also found that HIV patients on a regimen of a protease inhibitor plus a nonnucleoside reverse transcriptase inhibitor had the lowest reductions in total cholesterol and triglycerides of any of the HIV patients. Their mean reduction in total cholesterol was 17%, and their mean reduction in triglycerides was 16%.
The most common lipid-lowering therapy used in the patients and the controls was a statin, and pravastatin was used more commonly in the HIV patients than in the controls, Dr. Silverberg said.