ACTG A5275 was a prospective, double-blind, randomized, placebo-controlled cross-over design pilot study evaluating the effect of atorvastatin on biomarkers of inflammation, coagulopathy, angiogenesis, and T-lymphocyte activation in HIV-1 infected individuals with suppressed HIV-1 RNA on stable protease inhibitor based antiretroviral therapy with fasting LDL cholesterol \< 130 mg/dL. Atorvastatin is a drug approved by the Food and Drug Administration (FDA) for treating high cholesterol. Atorvastatin has also been able to lower the level of inflammation blood tests in certain other diseases but has not been studied for this purpose in people who have HIV. The main goal of this experimental study is to see how taking atorvastatin affects inflammation blood tests in people infected with HIV who do not need to take medicine for high cholesterol. In addition to observing the effects of atorvastatin on the level of inflammation measured in the blood, this study evaluated if atorvastatin is safe for people with HIV who are also taking medication for HIV.
Since people started taking HIV medications, illness from AIDS has decreased, but other serious diseases like heart disease (heart attacks) and certain kinds of cancer have increased. HIV causes inflammation (irritation) inside the body that cannot be felt but can be measured by levels of certain inflammation blood tests. Inflammation may contribute to diseases (such as heart attacks) that have become some of the leading causes of death in people with HIV. HIV therapy can partially lower levels of inflammation measured in blood, however, levels of inflammation in people who have HIV who are taking certain kinds of anti-HIV drugs may remain high compared with those found in people not infected with HIV.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
98
10 mg daily for 4 weeks, if no symptoms or lab findings suggestive of atorvastatin toxicity, dose increase to 20 mg daily from week 4- week 20
Starting at week 24, 10 mg daily for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, 20 mg daily from week 28- week 44.
One tablet once daily for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, then increase the dose to two tablets once daily.
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Difference Between [Change From Week 24 to Week 44] and [Change From Baseline to Week 20] in log10 IL-6
IL-6 (Interleukin 6) in log10 pg/mL: Difference between \[change from week 24 to week 44\] and \[change from baseline to week 20\] (i.e. \[week 44 - week 24\] - \[week 20 - baseline\])
Time frame: baseline, week 20, week 24, and week 44
Difference Between [Change From Week 24 to Week 44] and [Change From Baseline to Week 20] in CD4+ T-cell Activation Percent
CD4+ T-cell activation percent (% CD38+/DR+ of CD4+): Difference between \[change from week 24 to week 44\] and \[change from baseline to week 20\] (i.e. \[week 44 - week 24\] - \[week 20 - baseline\])
Time frame: baseline, week 20, week 24, and week 44
Difference Between [Change From Week 24 to Week 44] and [Change From Baseline to Week 20] in log10 D-dimer
D-dimer in log10 ng/mL: Difference between \[change from week 24 to week 44\] and \[change from baseline to week 20\] (i.e. \[week 44 - week 24\] - \[week 20 - baseline\])
Time frame: baseline, week 20, week 24, and week 44
Difference Between [Change From Week 24 to Week 44] and [Change From Baseline to Week 20] in CD8+ T-cell Activation Percent
CD8+ T-cell activation percent (% CD38+/DR+ of CD8+): Difference between \[change from week 24 to week 44\] and \[change from baseline to week 20\] (i.e. \[week 44 - week 24\] - \[week 20 - baseline\])
Time frame: baseline, week 20, week 24, and week 44
Difference Between [Change From Week 24 to Week 44] and Change From [Baseline to Week 20] in MCP-1 (log10 Transformed)
Monocyte chemoattractant protein-1 (MCP-1/CCL2) is one of the key chemokines that regulate migration and infiltration of monocytes/macrophages. Difference between \[change from week 24 to week 44\] and change from \[baseline to week 20\] is defined as \[week 44 - week 24\] - \[week 20 - baseline\].
Time frame: baseline, week 20, week 24, and week 44
Difference Between [Change From Week 24 to Week 44] and Change From [Baseline to Week 20] in IP-10 (log10 Transformed)
IFN-gamma-inducible protein 10 (IP-10 or CXCL10) is a chemokine secreted from cells stimulated with type I and II IFNs and LPS, is also a chemoattractant for activated T cells. Difference between \[change from week 24 to week 44\] and change from \[baseline to week 20\] is defined as \[week 44 - week 24\] - \[week 20 - baseline\].
Time frame: baseline, week 20, week 24, and week 44
Difference Between [Change From Week 24 to Week 44] and Change From [Baseline to Week 20] in CD40L (log10 Transformed)
Cluster of differentiation 40 (CD40L) is a costimulatory protein found on antigen presenting cells and is required for their activation. Difference between \[change from week 24 to week 44\] and change from \[baseline to week 20\] is defined as \[week 44 - week 24\] - \[week 20 - baseline\].
Time frame: baseline, week 20, week 24, and week 44
Difference Between [Change From Week 24 to Week 44] and Change From [Baseline to Week 20] in sCD14 (log10 Transformed)
Soluble cluster of differentiation 14 (sCD14) is a human gene. Difference between \[change from week 24 to week 44\] and change from \[baseline to week 20\] is defined as \[week 44 - week 24\] - \[week 20 - baseline\].
Time frame: baseline, week 20, week 24, and week 44
Difference Between [Change From Week 24 to Week 44] and Change From [Baseline to Week 20] in P-selectin (log10 Transformed)
P-selectin is a protein that in humans encoded by the SELP gene. P-selectin functions as a cell adhesion molecule (CAM) on the surfaces of activated endothelial cells, which line the inner surface of blood vessels, and activated platelets. Difference between \[change from week 24 to week 44\] and change from \[baseline to week 20\] is defined as \[week 44 - week 24\] - \[week 20 - baseline\].
Time frame: baseline, week 20, week 24, and week 44
Difference Between [Change From Week 24 to Week 44] and Change From [Baseline to Week 20] in sCD163 (log10 Transformed)
CD163 (Cluster of Differentiation 163) is a protein that in humans encoded by the CD163 gene; and sCD163 is soluble CD163. Difference between \[change from week 24 to week 44\] and change from \[baseline to week 20\] is defined as \[week 44 - week 24\] - \[week 20 - baseline\].
Time frame: baseline, week 20, week 24, and week 44
Number of Participants With Safety Endpoints Before Study Treatment Cross-over (Baseline to Week 24)
Safety endpoints are defined as grade ≥ 2 signs and symptoms, laboratory abnormalities, AST/ALT \> 3 X ULN, and adverse events prior to study treatment cross-over (baseline to week 24). The DAIDS Adverse Event (AE) Grading Table, Version 1.0, December 2004 (Clarification, August 2009) was used for grading of AEs.
Time frame: week 0 to week 24
Number of Participants With Safety Endpoints After Study Treatment Cross-over (Week 24 to Week 48)
Safety endpoints are defined as grade ≥ 2 signs and symptoms, laboratory abnormalities, AST/ALT \> 3 X ULN, and adverse events after study treatment cross-over (week 24 to week 48). The DAIDS Adverse Event (AE) Grading Table, Version 1.0, December 2004 (Clarification, August 2009) was used for grading of AEs.
Time frame: week 24 to week 48
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Georgetown University CRS (GU CRS) (1008)
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