Statins drugs are powerful anti-inflammatory agents in addition to their known lipid- lowering effects. In the general population, most cardiovascular events occur in subjects with normal or mildly elevated lipid levels, a population previously not targeted for statin therapy. Recently, the landmark JUPITER study changed the face of primary CVD prevention and recently, the FDA expanded the approval of statin therapy to include primary prevention of older subjects with hsCRP >2 mg/L, LDL-cholesterol <130 mg/dL, and one additional cardiovascular risk factor. However, the findings of JUPITER should not be automatically extrapolated to the pro-inflammatory state of HIV. Our hypothesis is that in HIV-infected patients with good virologic control, high CRP and normal LDL-C, rosuvastatin will improve endothelial function and decrease atherogenesis, and that rosuvastatin acts primarily as an anti-inflammatory and anti-oxidant agent. Also, because of the strong link between inflammation and osteoporosis in the general population, and the multiple animal and human studies showing a beneficial effect of statins on bone metabolism, we will use this unique opportunity to examine the effects of statins on skeletal health.
The specific aims will be investigated in a randomized, double-blind, placebo-controlled trial of 140 HIV-infected subjects who are on stable antiretroviral therapy and with good HIV virologic control, with LDL-C <130 mg/dL and hsCRP >2 mg/L. This study is novel in this population, and will have significant implications in future management of people living with HIV, specifically in better refining the indication of statin therapy in primary cardiovascular prevention.
People living with HIV are getting older and suffering from several complications of HIV and its therapy, including increased risk of heart disease and osteoporosis. This study will examine the effect of a potent statin medication on these complications and will aim to understand the driver of these complications in people living with HIV. Our goal is that by using a safe agent, like statins, we will be able to decrease the risk of cardiovascular disease and thin bones in people living with HIV. In addition, we will be able to better understand the role played by chronic inflammation and oxidant stress on these complications.
|Hileman, Corrilynn O; McComsey, Grace A (2018) Short Communication: The Effect of Rosuvastatin on Vascular Disease Differs by Smoking Status in Treated HIV Infection. AIDS Res Hum Retroviruses 34:282-285|
|El Kamari, Vanessa; Hileman, Corrilynn O; Gholam, Pierre M et al. (2018) Statin Therapy Does Not Reduce Liver Fat Scores in Patients Receiving Antiretroviral Therapy for HIV Infection. Clin Gastroenterol Hepatol :|
|Dirajlal-Fargo, Sahera; Kulkarni, Manjusha; Bowman, Emily et al. (2018) Serum Albumin Is Associated With Higher Inflammation and Carotid Atherosclerosis in Treated Human Immunodeficiency Virus Infection. Open Forum Infect Dis 5:ofy291|
|Perazzo, Joseph D; Webel, Allison R; Alam, S M Khurshid et al. (2018) Relationships Between Physical Activity and Bone Density in People Living with HIV: Results from the SATURN-HIV Study. J Assoc Nurses AIDS Care 29:528-537|
|Longenecker, Chris T; Margevicius, Seunghee; Liu, Yiying et al. (2017) Effect of Pericardial Fat Volume and Density on Markers of Insulin Resistance and Inflammation in Patients With Human Immunodeficiency Virus Infection. Am J Cardiol 120:1427-1433|
|Park, Michelle S; Hileman, Corrilynn O; Sattar, Abdus et al. (2017) Incidental findings on chest computed tomography are common and linked to inflammation in HIV-infected adults. Antivir Ther 22:127-133|
|Dirajlal-Fargo, Sahera; El Kamari, Vanessa; Sattar, Abdus et al. (2017) Effect of statin on arginine metabolites in treated HIV-infection. Atherosclerosis 266:74-80|
|Webel, A R; Sattar, A; Funderburg, N T et al. (2017) Alcohol and dietary factors associate with gut integrity and inflammation in HIV-infected adults. HIV Med 18:402-411|
|Hileman, Corrilynn O; Tangpricha, Vin; Sattar, Abdus et al. (2017) Baseline Vitamin D Deficiency Decreases the Effectiveness of Statins in HIV-Infected Adults on Antiretroviral Therapy. J Acquir Immune Defic Syndr 74:539-547|
|Al-Kindi, Sadeer G; Zidar, David A; McComsey, Grace A et al. (2017) Association of Anisocytosis with Markers of Immune Activation and Exhaustion in Treated HIV. Pathog Immun 2:138-150|
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