Bezafibrate, gemfibrozil, fenofibrate, atorvastatin or pravastatin as treatment for protease inhibitor-related hyperlipidaemia in patients with HIV infection

Aim of our open-label, randomized, prospective study is to evaluate the role of statins and fibrates in the management of protease inhibitor-associated hyperlipidaemia. Plasma lipid levels of 656 HIV-infected patients referred to our tertiary care centre and on protease inhibitor-based antiretroviral therapy since at least 12 months have been evaluated. All patients established with HIV viral load < 50 copies/mL and presenting hypertriglyceridaemia unresponsive to a hypolipidaemic diet and physical exercise, have been treated with bezafibrate, gemfibrozil, fenofibrate, pravastatin, or atorvastatin for 12 months. At the close of 1-year follow-up, fibrates led to a reduction of 40.7% and 21.9% versus baseline triglyceridaemia and cholesterolaemia, respectively (p<0.001), and statins led to a reduction of 32.9% and 24.7% versus baseline triglyceride and total cholesterol levels, respectively (p<0.001), without significant differences according to different administered drugs.