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Cholesterol Screening and Statin Prescription is Low Among HIV-Infected Patients on Protease-Inhibitor Regimens in

M Mosepele1, V Letsatsi2, L Mokgatlhe3

  • 1Faculty of Medicine, University of Botswana, Gaborone, Botswana.

The Open AIDS Journal
|August 26, 2017
PubMed

Insights

In Botswana, HIV patients on protease inhibitors (PIs) showed low cholesterol screening rates and statin use, despite many qualifying for treatment. This indicates a significant gap in cardiovascular disease (CVD) risk management.

Area of Science:

  • Public Health
  • HIV Medicine
  • Cardiology

Background:

  • Limited data exists on statin use for cardiovascular disease (CVD) risk reduction in HIV-infected patients on protease inhibitors (PIs) in sub-Saharan Africa (SSA).
  • Cardiovascular risk management is crucial for HIV patients, especially those on specific antiretroviral therapies.

Purpose of the Study:

  • To assess cholesterol screening and statin utilization among HIV-infected patients on PIs in Botswana.
  • To evaluate the gap between statin indication and prescription for CVD risk reduction in this population.

Main Methods:

  • Retrospective analysis of HIV-infected patients on PIs from 2008-2012 at a Botswana HIV clinic.
  • Calculation of annual cholesterol screening proportions.
  • Assessment of statin indication using 2012 Atherosclerosis CVD (ASCVD) and Framingham Risk Score (FRS) guidelines.

Main Results:

  • Annual cholesterol screening increased from 19-30% (2008-2011) to 80% post-enrollment.
  • In 2012, 31% of patients had hypercholesterolemia (> 5.0 mmol/L).
  • Fewer than 1% were on statins, yet 14.3% (ASCVD) and 9.4% (FRS) met criteria for statin therapy.

Conclusions:

  • A significant gap exists in prescribing statins to indicated HIV patients on PIs in Botswana.
  • There is a critical need to improve CVD risk management strategies for this vulnerable population.
  • Initiating statin therapy for eligible patients could reduce future cardiovascular events.
Abstract

Keywords:
Cardiovascular riskCholesterolHIV-1 infectionProtease inhibitorStatinSub-Saharan Africa

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