Patients Living With HIV Are Less Likely to Receive Appropriate Statin Therapy for Cardiovascular Disease Risk...

Area of Science:

• Cardiology
• Infectious Diseases
• Pharmacology

Background:

• Patients living with HIV (PLWH) face increased risk of atherosclerotic cardiovascular disease (ASCVD).
• Studies indicate statins may be underprescribed in PLWH at risk for ASCVD.
• Previous research has not compared appropriate statin intensity between eligible PLWH and uninfected individuals.

Purpose of the Study:

• To determine if statin-eligible PLWH receive appropriate statin therapy less often than patients without HIV.
• To identify disparities in statin prescribing for ASCVD risk reduction in PLWH.

Main Methods:

• Retrospective study of statin eligibility and prescribing from June-September 2018.
• Utilized American College of Cardiology/American Heart Association cholesterol guidelines.
• Compared statin treatment appropriateness between HIV-infected and uninfected patient groups using chi-square and logistic regression.

Main Results:

• 221 out of 300 subjects were eligible for statin therapy.
• Only 30.2% of eligible PLWH received appropriate statin intensity versus 67.0% of controls (p < 0.001).
• PLWH were significantly less likely to receive appropriate statin therapy; polypharmacy was associated with appropriate therapy.

Conclusions:

• PLWH are at a disadvantage in receiving appropriate statin therapy for ASCVD risk reduction.
• This care gap is critical given the elevated ASCVD risk in PLWH.
• Strategies to improve statin prescribing for ASCVD prevention in PLWH are needed.