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Cardiovascular risk and response to lipid lowering therapy in patients with HIV infection according to different

Agnieszka Pawlos1, Marlena Broncel1, Ewelina Wlazłowska2

  • 1Department of Internal Diseases and Clinical Pharmacology, Medical University of Lodz, Lodz, Poland.

Plos One
|December 29, 2020
PubMed

Insights

HIV patients face high cardiovascular risk, but achieving lipid goals is poor, especially with statin therapy. Current hypolipemic treatment in HIV patients uses low statin doses, indicating a need for better cardiovascular risk management.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Human Immunodeficiency Virus (HIV) infection is associated with increased cardiovascular disease (CVD) risk.
  • Existing European cardiovascular guidelines offer ambiguous recommendations for managing CVD risk in HIV patients.
  • Effective CVD risk stratification and management are crucial for this growing population.

Purpose of the Study:

  • To evaluate cardiovascular risk in HIV patients using established risk scales.
  • To assess the effectiveness of current hypolipemic treatments based on European guidelines.
  • To identify gaps in achieving therapeutic lipid levels in HIV-positive individuals.

Main Methods:

  • A retrospective analysis of 389 HIV patients was performed.
  • Cardiovascular risk was assessed using D:A:D, Framingham, and SCORE scales.
  • Patients were categorized into risk groups per EACS 2019, PTN AIDS 2019, and ESC/EAS 2019 guidelines, with hypolipemic treatment evaluated.

Main Results:

  • Over 92% of HIV patients were classified as high or very high cardiovascular risk by ESC/EAS and PTN AIDS guidelines.
  • Achievement of target LDL cholesterol levels was unsatisfactory across all guidelines, particularly for patients on lipid-lowering therapy.
  • Lipid-lowering treatment in HIV patients often involved low doses of statins, even in secondary prevention cases.

Conclusions:

  • Current therapeutic goal achievement for LDL cholesterol in HIV patients is inadequate according to all assessed guidelines.
  • Lipid-lowering therapy in this cohort is suboptimal, characterized by low statin dosages.
  • There is a critical need to optimize cardiovascular risk management strategies and hypolipemic treatment in HIV-infected individuals.
Abstract

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