Pitavastatin as the preferred statin for control of dyslipidemia in patients with HIV infection using antiretrovirals

Objective: explain why pitavastatin is the lipid-lowering agent of choice for lipid control and cardiovascular risk reduction in people infected with HIV. Methods: Searches were carried out inPubMed and the Virtual Health Library (VHL), using these descriptors, in English and Portuguese: “Pitavastat...

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Bibliographic Details
Authors: Monteiro Borges da Silva Valente, Thiago José, Pacífico, Fernando Augusto, Campos Falcão, Antônio Diego
Format: article
Status:Published version
Publication Date:2023
Country:Brasil
Institution:Faculdade de Medicina de Olinda (FMO)
Repository:Anais da Faculdade de Medicina de Olinda (Online)
Language:Portuguese
English
OAI Identifier:oai:ojs.afmo.emnuvens.com.br:article/279
Online Access:https://afmo.emnuvens.com.br/afmo/article/view/279
Access Level:Open access
Keyword:Antirretrovirais
HIV
Hiperlipidemia
Hipolipemiantes
Estatinas
Antiretrovirals
Hyperlipidemia
Hypolipidemic
Statins
Description
Summary:Objective: explain why pitavastatin is the lipid-lowering agent of choice for lipid control and cardiovascular risk reduction in people infected with HIV. Methods: Searches were carried out inPubMed and the Virtual Health Library (VHL), using these descriptors, in English and Portuguese: “Pitavastatin”, “HIV”, “Statins”, “Infected by HIV”, “Dyslipidemia” and “Antiretrovirals”. 46 articles were retrieved, reduced, after refinement, to 9, 6 from PubMed and 3 from VHL. Results: The use of antiretrovirals (ARVs) significantly increases lipid alterations in HIV-infected people and should be associated with lipid-lowering therapy with statins. However, as most of them are metabolized by the cytochrome P450 3A4 system, which is inhibited by some ARVs, pitavastatin stands out, since its metabolization process occurs primarily by glucuronidation. Furthermore, it was provedthat this statin showed more inflammatory markers and LDL-c levels than pravastatin, which is metabolized through the same mechanism. Conclusion: Therefore, pitavastatin is preferably the lipid-lowering agent to correct dyslipidemia in HIV-infected patients, due to its minimal drug reactions and greater reduction in lipids and inflammatory markers.