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Achievement of LDL cholesterol targets in HIV-positive patients: a single center cohort study

Antonio Delle Cave1, Chiara Tognola2, Marco Bellomare1

  • 1School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.

Nutrition, Metabolism, and Cardiovascular Diseases : NMCD
|May 2, 2026
PubMed

Insights

Cardiovascular risk management in people living with HIV (PLWH) is challenging. Achieving LDL-C targets remains suboptimal, indicating a need for tailored prevention strategies for this population.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • People living with HIV (PLWH) have elevated cardiovascular (CV) risk due to chronic inflammation, ART, and traditional risk factors.
  • Standard CV risk models often underestimate risk in PLWH.
  • ART can have metabolic effects contributing to increased CV risk.

Purpose of the Study:

  • To evaluate CV risk categories and LDL-C targets in PLWH.
  • To assess the achievement rate of recommended LDL-C targets.
  • To identify factors associated with LDL-C target achievement in PLWH on ART.

Main Methods:

  • Retrospective analysis of 246 PLWH aged ≥40 on ART.
  • Utilized electronic health records for clinical and laboratory data.
  • Assessed 10-year CV risk using the SCORE2 model.

Main Results:

  • Only 27.2% of PLWH achieved their LDL-C targets.
  • Lower achievement rates were observed in high and very-high CV risk categories.
  • Patients achieving targets had better CV profiles (lower LDL-C, SBP) but no significant relation to HIV-specific variables.

Conclusions:

  • LDL-C target achievement is suboptimal in PLWH, suggesting inadequate CV risk control.
  • Current strategies may not sufficiently address the CV risk burden in this population.
  • More aggressive and HIV-tailored prevention strategies are needed for effective CV risk management.
Abstract

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