Effects of rosuvastatin versus pravastatin on low-density lipoprotein diameter in HIV-1-infected patients receiving ritonavir-boosted protease inhibitor

AIDS. 2012 Sep 10;26(14):1801-5. doi: 10.1097/QAD.0b013e328357063c.

Abstract

Objective: HIV infection is associated with an atherogenic lipoprotein profile, and ritonavir-boosted protease inhibitors exacerbate this phenotype. We evaluated the effect of 45 days of rosuvastatin versus pravastatin on the low-density lipoprotein (LDL) size and the distribution of LDL subfractions in HIV-1 patients receiving boosted protease inhibitors with elevated LDL levels.

Design: Substudy of the randomized double-blind multicentre ANRS 126 VIHstatine trial.

Setting: Twenty clinical centres in France.

Patients: HIV-infected patients receiving boosted protease inhibitors with dyslipidaemia (LDL cholesterol > 4.1 mmol/l and triglycerides < 8.8 mmol/l).

Intervention: Rosuvastatin 10 mg/day (n = 39) or pravastatin 40 mg/day (n = 37) for 45 days.

Main outcome measure(s): LDL size and distribution of LDL subfractions blindly assessed by gradient gel electrophoresis at baseline and at day 45.

Results: Rosuvastatin was more effective than pravastatin in increasing the diameter of the LDL peak. The LDL diameter change was 0.33 ± 0.59 nm in the rosuvastatin group versus -0.01 ± 0.52 nm in the pravastatin group (P = 0.021). Rosuvastatin was also more effective in increasing significantly the percentage of large LDL (LDL1, P = 0.038; LDL2, P = 0.031) and in decreasing the percentage of small LDL (LDL3, P = 0.009).

Conclusion: Rosuvastatin was more effective than pravastatin in normalizing LDL size and LDL subfraction distributions, leading to a less atherogenic phenotype.

Trial registration: ClinicalTrials.gov NCT00117494.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anticholesteremic Agents / therapeutic use*
  • Cholesterol, LDL / blood*
  • Cholesterol, LDL / drug effects
  • Double-Blind Method
  • Dyslipidemias / blood*
  • Dyslipidemias / drug therapy
  • Dyslipidemias / etiology
  • Female
  • Fluorobenzenes / therapeutic use*
  • Frankreich
  • HIV Protease Inhibitors / administration & dosage*
  • HIV Seropositivity / blood*
  • HIV Seropositivity / complications
  • HIV Seropositivity / drug therapy
  • HIV-1 / metabolism*
  • Humans
  • Male
  • Middle Aged
  • Pravastatin / therapeutic use*
  • Pyrimidines / therapeutic use*
  • Ritonavir / administration & dosage*
  • Rosuvastatin Calcium
  • Sulfonamides / therapeutic use*
  • Treatment Outcome

Substances

  • Anticholesteremic Agents
  • Cholesterol, LDL
  • Fluorobenzenes
  • HIV Protease Inhibitors
  • Pyrimidines
  • Sulfonamides
  • Rosuvastatin Calcium
  • Pravastatin
  • Ritonavir

Associated data

  • ClinicalTrials.gov/NCT00117494