Ezetimibe as lipid-lowering therapy for patients receiving HAART

Background

Dyslipidaemia in HIV has been linked with both a cytokine-driven lipid metabolism re-arrangement in significant viraemia, and with the use of highly-active antiretroviral therapy (HAART), especially protease inhibitors (PIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs).

Methods

This study was a retrospective review, evaluating the efficacy and safety of Ezetimibe in our cohort of HIV-positive patients stable on HAART with dyslipidaemia. Out of the 29 such individuals prescribed 10 mg Ezetimibe once daily, 17 received it in addition to a statin, and 12 received it as a direct replacement for a statin.

Summary of results

Prior to initiation of Ezetimibe, median serum total cholesterol and triglyceride levels were 6.3 mmol/l (range: 3.6–10.7) and 2.9 mmol/l (range: 0.54–13.02), respectively. Review of the lipid profiles of the cohort after 12 weeks of Ezetimibe therapy revealed (see data in Figure 1). Two individuals discontinued Ezetimibe prematurely.

Conclusion

These results suggest that Ezetimibe may have an important role as an effective therapy for HAART-induced dyslipidaemia.

Figure 1