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Policosanol for managing human immunodeficiency virus-related dyslipidemia in a medically underserved population: a
Barbara Swanson1, Joyce K Keithley, Beverly E Sha
1Rush University College of Nursing, Chicago, Illinois, USA. Barbara_a_swanson@rush.edu
Insights
Policosanol, a sugar cane supplement, did not normalize lipid levels in HIV-infected individuals. This dietary supplement was well-tolerated and did not impact HIV disease markers.
Area of Science:
- Cardiology
- Infectious Diseases
- Nutritional Science
Background:
- Human immunodeficiency virus (HIV) infection is linked to dyslipidemia and cardiovascular risks.
- Statins are often complicated by drug interactions and toxicities in HIV patients.
- Policosanol, a sugar cane derivative, is used as a statin alternative in some regions.
Purpose of the Study:
- To assess the feasibility of sugar cane-derived policosanol in normalizing dyslipidemia in medically underserved HIV-infected individuals.
- To evaluate the efficacy and safety of policosanol as a lipid-modulating agent in this population.
Main Methods:
- A randomized, controlled, double-blind, crossover trial was conducted.
- Fifty-four HIV-infected participants with lipid abnormalities received 20 mg/day of policosanol or placebo for 12 weeks.
- Lipid profiles and NMR-derived lipoprotein particles were measured; safety was monitored via CD4 counts and HIV RNA levels.
Main Results:
- Policosanol supplementation did not normalize dyslipidemic parameters on standard lipid panels or NMR spectroscopy.
- No significant changes were observed in lipoprotein size or concentration.
- The supplement was well-tolerated and did not affect HIV disease progression markers.
Conclusions:
- Findings suggest policosanol has no significant lipid-modulating effects in HIV-infected individuals.
- These results align with other studies outside Cuba that found no lipid benefits from policosanol.
- Policosanol appears safe but ineffective for dyslipidemia in this population.
Background:
Human immunodeficiency virus (HIV) infection is associated with dyslipidemia and increased risk for cardiovascular events; however, the use ofstatins in HIV-infected people is complicated by pharmacokinetic interactions and overlapping toxicities with antiretroviral medications. Policosanol is a dietary supplement derived from sugar cane that is widely used as a statin alternative in Latin America.
Primary Study Objective:
To collect feasibility data on sugar cane-derived policosanol to normalize dyslipidemic profiles in a sample of medically underserved HIV-infected people.
Methods/Design:
Randomized, controlled, double-blind clinical trial.
Setting:
Two infectious disease outpatient clinics located in a Health Resources Service Administration-designated medically underserved neighborhood in Chicago, Illinois.
Participants:
Fifty-four clinically stable HIV-infected people (91% black) with at least one lipid abnormality that warranted dietary modifications and/or drug therapy.
Intervention:
Participants received either 20 mg/day of policosanol or placebo for 12 weeks, followed by a 4-week washout and crossover to the other arm.
Primary Outcome Measures:
Efficacy measures included the standard lipid panel (low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides) and nuclear magnetic resonance (NMR)-derived lipoprotein particle profiles. Safety measures included CD4+ T lymphocyte counts, plasma HIV ribonucleic acid levels, serum creatinine, and liver function tests.
Results:
Policosanol supplementation was not associated with normalization of any dyslipidemic parameters as measured by the standard lipid panel or NMR spectroscopy-measured lipoprotein size or concentration. The supplement was well tolerated and was not associated with any changes in parameters of HIV disease progression.
Conclusions:
Our findings corroborate recent studies conducted outside Cuba that have failed to find any lipid modulatory effects for policosanol.
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