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Benefits and Risks of Statin Therapy in the HIV-Infected Population

Mosepele Mosepele1,2,3, Onkabetse J Molefe-Baikai4, Steven K Grinspoon5

  • 1Department of Internal Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana. mosepelemosepele@gmail.com.

Current Infectious Disease Reports
|May 28, 2018
PubMed

Insights

HIV patients have a higher risk of cardiovascular disease (CVD). Statins are underutilized in this population, but pitavastatin shows promise due to fewer drug interactions with antiretroviral therapy (ART).

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pharmacology

Background:

  • HIV infection significantly increases cardiovascular disease (CVD) risk (1.5-2x) compared to HIV-uninfected individuals.
  • Cardiovascular disease (CVD) prevention in HIV patients is crucial due to increased risk factors.

Purpose of the Study:

  • To review the role of statin therapy in reducing CVD risk in HIV-infected patients on antiretroviral therapy (ART).
  • To summarize recent findings (last 5 years) on statin use for CVD risk reduction in HIV populations.

Main Methods:

  • Review of recent literature (within 5 years) on statin therapy and CVD risk in HIV-infected patients.
  • Analysis of clinical guidelines and studies on statin utilization and efficacy in HIV populations.

Main Results:

  • Statins are recommended for CVD risk reduction in HIV patients, extrapolated from general population guidelines, but are underprescribed.
  • Rosuvastatin and atorvastatin are commonly studied, offering potent lipid-lowering and favorable pleiotropic effects.
  • Pitavastatin demonstrates comparable lipid-lowering with fewer adverse drug interactions with ART and no impact on glucose metabolism, making it a preferred agent.

Conclusions:

  • Statins are underutilized for CVD prevention in HIV-infected patients despite established guidelines.
  • Pitavastatin emerges as a promising option due to its favorable interaction profile with ART.
  • Ongoing trials will further define the role of statin therapy, including for patients not meeting current guideline criteria.
Abstract

Keywords:
Atherosclerotic cardiovascular diseaseHIVInflammationPreventionStatin

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