A 1-year treatment with rosuvastatin significantly reduced serum concentrations of high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in people with HIV and metabolic syndrome (MetS), according to a small Italian study published in Infectious Diseases. Furthermore, when comparing people with HIV with those with or without MetS, patients with MetS showed a slower rate of atherosclerosis progression.
This prospective cohort study enrolled 125 people with HIV (mean age, 47.8 years; White, 90.4%; men, 80.8%) on a stable combination antiretroviral therapy. Study investigators compared the effects of rosuvastatin (10 mg daily) on inflammatory markers and carotid intima-media thickness (IMT) after 12 months between those with MetS (MetS group, n=61) and those without MetS (control group, n=64).
At baseline, demographic and clinical characteristics were similar between the MetS and control groups. Both groups also had similar levels of total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, inflammatory markers, and carotid IMT values.
At 12-month follow-up, there was a significant reduction in mean serum concentrations of hsCRP (-0.28; 95% CI, -0.51 to -0.09; P =.037), IL-6 (-2.1; 95% CI, -3.4 to -.09; P =.018), and TNF-α (-6.3; 95% CI, -9.8 to -3.1; P =.004) in the MetS group.
While there was a reduction for each of these 3 markers in the control group as well, only mean serum concentrations of hsCRP saw statistically significant changes (P =.288); IL-6 (P =.447), and TNF-α (P =.775) did not. Changes between the MetS and control groups were statistically significant (P =.004; P =.011; P =.018, respectively)
Aside from changes in HDL cholesterol, both the MetS and the control group had similar significant decreases in mean serum concentration of total cholesterol, LDL cholesterol , and triglycerides at 12 months vs baseline.
While the mean carotid IMT values increased in the MetS group in all anatomical sites, the increases were not statistically significant. However, the mean IMT values in the control group was significantly increased in all anatomical sites (carotid bifurcations, common carotid arteries, and internal carotid arteries) and were even more pronounced when compared with the mean change in the MetS group at 12 months, indicating that the MetS group had a slower progression of atherosclerosis rate compared with the control group.
Both groups showed comparable adverse events. The most common symptoms of which were gastrointestinal, myalgias or arthralgias, headache, and fatigue.
Limitations of this study included its small sample size, and evaluation of only one statin at one dosage. The study did not include lifestyle differences, such as diet and exercise, nor explore the potential role of combination antiretroviral therapy with prevalence of MetS. In addition, adherence to drug therapies were evaluated using only self-reported questionnaires.
Larger, randomized studies are needed “to better define all the biological properties of statins and their potential favorable effects in order to reduce the long-term cardiovascular disease risk among HIV-infected patients with metabolic disorders,” the researchers concluded.
Calza L, Colangeli V, Borderi M, et al. Rosuvastatin decreases serum inflammatory markers and slows atherosclerosis progression rate in treated HIV-infected patients with metabolic syndrome. Infect Dis (Lond). 2021;53(2):81-88. doi:10.1080/23744235.2020.1823468