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High Dose Atorvastatin Decreases Cellular Markers of Immune Activation without Affecting HIV-1 RNA Levels: Results of a Double-Blind Randomized Placebo Controlled Clinical Trial

Title: High Dose Atorvastatin Decreases Cellular Markers of Immune Activation without Affecting HIV-1 RNA Levels: Results of a Double-Blind Randomized Placebo Controlled Clinical Trial
Authors: Ganesan, Anuradha; Crum-Cianflone, Nancy; Higgins, Jeanette; Qin, Jing; Rehm, Catherine; Metcalf, Julia; Brandt, Carolyn; Vita, Jean; Decker, Catherine F.; Sklar, Peter; Bavaro, Mary; Tasker, Sybil; Follmann, Dean; Maldarelli, Frank
Publisher Information: Oxford University Press
Publication Year: 2011
Collection: HighWire Press (Stanford University)
Subject Terms: Major Article
Description: Background . 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitors (statins) exhibit antiviral activity against human immunodeficiency virus type 1 (HIV-1) in vitro and may modulate the immune response to HIV infection. Studies evaluating the antiviral activity of statins have yielded conflicting results. Methods . We conducted a randomized, double-blind, placebo-controlled crossover trial to investigate the effect of atorvastatin on HIV-1 RNA (primary objective) and cellular markers of immune activation (secondary objective). HIV-infected individuals not receiving antiretroviral therapy were randomized to receive either 8 weeks of atorvastatin (80 mg) or placebo daily. After a 4–6 week washout phase, participants switched treatment assignments. The study had 80% power to detect a 0.3 log 10 decrease in HIV-1 RNA level. Expression of CD38 and HLA-DR on CD4+ and CD8+ T cells was used to measure immune activation. Results . Of 24 randomized participants, 22 completed the study. Although HIV-1 RNA level was unaffected by the intervention (–0.13 log 10 copies/mL; P = .85), atorvastatin use resulted in reductions in circulating proportions of CD4+ HLA-DR+ (–2.5%; P = .02), CD8+ HLA-DR+ (–5%; P = .006), and CD8+ HLA-DR+ CD38+ T cells (–3%; P = .03). Reductions in immune activation did not correlate with declines in serum levels of low-density lipoprotein cholesterol. Conclusions . Short-term use of atorvastatin was associated with modest but statistically significant reductions in the proportion of activated T lymphocytes.
Document Type: text
File Description: text/html
Language: English
Relation: http://jid.oxfordjournals.org/cgi/content/short/jiq115v1; http://dx.doi.org/10.1093/infdis/jiq115
DOI: 10.1093/infdis/jiq115
Availability: http://jid.oxfordjournals.org/cgi/content/short/jiq115v1; https://doi.org/10.1093/infdis/jiq115
Rights: Copyright (C) 2011, Infectious Diseases Society of America
Accession Number: edsbas.E3E9326B
Database: BASE