Effects of 96 Weeks of Rosuvastatin on Bone, Muscle, and Fat in HIV-Infected Adults on Effective Antiretroviral Therapy

AIDS Res Hum Retroviruses. 2016 Apr;32(4):311-6. doi: 10.1089/AID.2015.0191. Epub 2015 Nov 16.

Abstract

Heightened inflammation and immune activation are associated with lower bone mineral density (BMD) and lean body mass (LBM) among HIV-infected persons. We hypothesized that a reduction in inflammation with rosuvastatin would be associated with improvements in BMD and LBM. HIV-infected participants on stable antiretroviral therapy without statin indication and with heightened immune activation (≥19% CD8(+)CD38(+)HLA-DR(+) T cells) or inflammation (hsCRP ≥2 mg/liter) were randomized to rosuvastatin 10 mg daily or placebo for 96 weeks. Among 72 participants randomized to rosuvastatin and 75 to placebo, there were no significant differences in the relative changes in BMD (p > 0.29) or in fat (p ≥ 0.19). A trend toward increased LBM (p = 0.059) was seen in the rosuvastatin arm without differences in creatinine kinase or self-reported physical activity (p ≥ 0.10). In a multivariable regression model, rosuvastatin was associated with a significant positive effect on LBM after adjusting for age, sex, race, smoking status, and detectable HIV-1 viral load. Higher baseline sCD163 correlated with increases in LBM from weeks 0 to 96 (p = 0.023); greater changes in total and leg lean mass were seen among statin users with higher compared to lower baseline IP-10 levels (LBM 1.8 vs. -0.3%; p = 0.028 and leg lean mass 2.9 vs. -1.7%; p = 0.012). Rosuvastatin is associated with an absence of toxicity on BMD and a potential benefit on LBM over 96 weeks of therapy. The preservation of LBM in the rosuvastatin arm over the 2 years of the study is of major clinical relevance in delaying loss of muscle mass with aging.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipose Tissue / pathology
  • Adolescent
  • Adult
  • Anti-Retroviral Agents / therapeutic use*
  • Anticholesteremic Agents / therapeutic use*
  • Bone and Bones / pathology
  • Double-Blind Method
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / pathology*
  • Humans
  • Inflammation / pathology*
  • Male
  • Middle Aged
  • Muscles / pathology
  • Placebos / administration & dosage
  • Rosuvastatin Calcium / therapeutic use*
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Retroviral Agents
  • Anticholesteremic Agents
  • Placebos
  • Rosuvastatin Calcium