Pitavastatin is a pharmaceutical agent studied for its potential in treating People Living with HIV, or PLHIV, who also have dyslipidemia and are receiving ritonavir-boosted atazanavir (ATV/r) as part of their antiretroviral therapy (ART). Dyslipidemia is the imbalance of lipids such as cholesterol, triglycerides, low-density lipoprotein cholesterol ("good" cholesterol - LDL) and high-density lipoprotein ("bad" cholesterol - HDL) It is normally treated with “statins”, a class of medications proven to be effective in lowering cholesterol. Pitavastatin is classified as a statin, which is known for its lipid-lowering effects and ability to reduce cholesterol levels.
A new study published in AIDs Research and Therapy observed the association of using this specific statin on dyslipidemia in people living with HIV. The study was conducted as a randomized, double-blind, crossover trial involving 24 PLHIV participants with dyslipidemia and receiving ATV/r.
The main objective of the study was to investigate the effects of pitavastatin on atherosclerotic-associated inflammatory biomarkers in PLHIV. To do this, several analyses were performed on the participants receiving the drug as well as those not receiving the drug. Immunophenotyping was conducted using peripheral blood mononuclear cells (PBMCs) to identify cellular markers. Pitavastatin treatment showed no significant effect on hs-CRP levels, which is an indicator of inflammation. However, it did result in significant changes in the levels of basic fibroblast growth factor (FGF). Basic FGF is known to have atherosclerotic-protective effects and improves myocardial perfusion, making its increase a positive outcome.
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Pitavastatin treatment led to reductions in the percentages of immune cell subsets like T cells, CD4+ T cells, CD8+ T cells, and monocytes, which suggests a potential immunomodulatory effect of the drug. This reduction in T cell activation and exhaustion may have implications for lowering immune activation in PLHIV.
Overall, the study provided valuable insights into the effects of pitavastatin on atherosclerotic-associated inflammatory biomarkers in PLHIV with dyslipidemia receiving ATV/r. The findings highlight the potential benefits of using pitavastatin as a complementary therapy in this population to address cardiovascular disease risk associated with HIV infection and ART.
As the study paves the way for further research, larger controlled trials and mechanistic investigations are warranted to fully understand pitavastatin's role in improving outcomes for PLHIV with dyslipidemia.
Sources: MedlinePlus, Pan American Health Organization, National Library of Medicine, Mayoclinic, National Library of Medicine, News Medical Life Sciences, Medline Gov, British Society for Immunology, Cleveland Clinic
