People taking HIV meds may benefit from yet another combo—but this one won’t block the virus. A recent study in Spain showed that folks who added a cholesterol-lowering drug (Zetia) to a statin (Pravachol) reduced high cholesterol better than those who took Pravachol alone.
Does this approach sound familiar? It should: Hitting cholesterol on multiple fronts is similar to the way we attack HIV. Researchers combined Zetia, which keeps the intestine from absorbing the cholesterol, with Pravachol, which blocks enzymes responsible for cholesterol production, in 18 folks with HIV-med-related high cholesterol. (Too much cholesterol—a blood fat, or lipid—can hurt the heart.) After six months, 61% dropped their LDL (“bad”) cholesterol to the study goal of below 130. Federal guidelines say LDL below 100 is best, but that readings under 130 also reduce the risk of cardio harm.
Certain HIV meds—along with the virus itself, fatty foods and aging—can increase your LDL, promoting heart disease. For many people with HIV, the widely prescribed statin drugs, like Pravachol and Lipitor, don’t reduce LDL enough to reduce the risk of heart attack or stroke. With Zetia, they may.
The Pravachol-Zetia news gladdens docs. Says Boston’s Cal Cohen, MD, “Anything that can [reduce cholesterol levels in positive folks] is important.” New York City’s Donald Kotler, MD, calls the lipid-lowering strategy “an advance.” Bless their hearts.