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Maintenance of statin therapy among people living with HIV

David C Boettiger1,2,3, Stephen Kerr3,4, Pairoj Chattranukulchai5

  • 1Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.

AIDS (London, England)
|November 30, 2020
PubMed

Insights

Statin therapy maintenance is poor for people living with HIV (PLHIV) on antiretroviral therapy (ART), with over 60% discontinuing within 5 years. Discontinuation was linked to lower education, while reinitiation depended on age and comorbidities.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Statins are crucial for reducing atherosclerotic cardiovascular disease (ASCVD) risk in people living with HIV (PLHIV).
  • Maintaining statin therapy can be challenging for PLHIV due to potential antiretroviral therapy (ART)/statin interactions.
  • Understanding statin adherence patterns is vital for ASCVD risk management in this population.

Purpose of the Study:

  • To estimate rates of statin discontinuation and reinitiation among PLHIV on ART.
  • To determine the percentage of days covered by statin use in PLHIV.
  • To identify factors associated with statin discontinuation and reinitiation.

Main Methods:

  • An observational cohort study analyzed clinical data from 318 PLHIV between 2001 and 2020.
  • Kaplan-Meier curves and competing-risk regression were used to assess statin discontinuation and reinitiation rates.
  • Generalized estimating equations evaluated factors associated with statin use and coverage.

Main Results:

  • Within 5 years, 61.1% of PLHIV discontinued statin therapy; 52.0% of those who discontinued later reinitiated.
  • Statin discontinuation was associated with lower education, fewer concomitant medications, and absence of ASCVD.
  • Older age, diabetes, and high LDL cholesterol levels were linked to statin reinitiation.

Conclusions:

  • Statin therapy maintenance is suboptimal in PLHIV on ART, irrespective of ART/statin interactions.
  • Identifying factors influencing statin adherence is essential for effective ASCVD risk reduction strategies in PLHIV.
  • Improved understanding can guide clinical practice and public health interventions for managing cardiovascular risk in this population.
Abstract

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