Antiretroviral and Statin Drug-Drug Interactions

Patients living with the human immunodeficiency virus (HIV) are at risk for dyslipidemia as a result of the disease itself and from certain classes of antiretroviral therapy. The protease inhibitors and non-nucleoside reverse transcription inhibitors have been associated with elevated triglycerides, total, and low-density lipoprotein cholesterol with decreased high-density lipoprotein. These classes of medications affect the cytochrome P450 (CYP) enzyme resulting in both induction and inhibition of numerous CYP enzymes. The statins are extensively metabolized by the CYP system and therefore drug-drug interactions between the statins and antiretroviral therapy must be considered when treating HIV or antiretroviral drug-induced dyslipidemia.