P43
HIGH-DOSE ROSUVASTATIN SIGNIFICANTLY INCREASES SERUM VITAMIN D
CONCENTRATION IN HIV-INFECTED PATIENTS ON COMBINATION
ANTIRETROVIRAL THERAPY
Calza L1, Magistrelli E1, Colangeli V1, Borderi M1, Rosselli Del Turco E1,
Bussini L1, Bon I2, Re MC2, Viale P1
Department of Medical and Surgical Sciences, 1Clinics of Infectious Diseases, and
2Unit of Microbiology, S.Orsola-Malpighi Hospital, University of Bologna
Background. Some clinical studies have shown an increase in serum levels of vitamin D
induced by a statin treatment in the general population. However, the interaction between
statins and vitamin D is unclear still today, and very limited data are available in HIVinfected people.
Methods. A prospective, cohort study was conducted to assess the effect of a
rosuvastatin therapy on 25-OH vitamin D serum concentrations among HIV-positive adults
on stable combination antiretroviral therapy (cART) in our Outpatient Unit.
Results. A total of 44 patients (32 males, mean age 49.2 years) starting a lipid-lowering
treatment with rosuvastatin for any indication were enrolled into the study. Rosuvastatin
dose was 10 mg daily in 36 patients and 20 mg daily in 8. Current cART included a
ritonavir-boosted protease inhibitor in the 58% of patients and efavirenz in the 34%. The
baseline median concentration of total cholesterol, LDL cholesterol and vitamin D was 255
mg/dL (IQR, 227; 279), 157 mg/dL (IQR, 131; 178) and 19.1 ng/mL (IQR, 13.2; 26.5),
respectively, and the 57% of patients had a vitamin D deficiency (<20 ng/mL). After 6 and
12 months, a significant increase in the mean level of vitamin D was reported in
comparison with the baseline values: +4.2 ng/mL (IQR, +2.7; +5.6; p=0.003) and +4.5 ng/
mL (IQR, +2.6; +5.8; p=0.016), respectively. At the end of follow-up there was a significant
reduction in the number of patients with vitamin D deficiency (23%; p=0.021), and a
significant reduction in total and LDL cholesterol levels: -48 mg/dL (IQR, -62; -29;
p=0.003) and -31 mg/dL (IQR, -46; -19; p<0.001), respectively. During the follow-up, 6
patients (13.6%) discontinued the statin therapy because of myalgia or gastrointestinal
symptoms, and 3 subjects (6.8%) changed current cART because of virological failure or
adverse events.
Discussion. In our observational study, a high-dose treatment with rosuvastatin for 12
months produced a significant increase in the serum vitamin D level, suggesting a
potential biological correlation between the pleiotropic benefits of statins and vitamin D
also in HIV-infected people.