Extreme Cardiovascular Risk and LDL-C Target Achievement in People With HIV

Area of Science:

• Cardiology
• Infectious Diseases
• Public Health

Background:

• A significant number of individuals with human immunodeficiency virus (HIV) also have established atherosclerotic cardiovascular disease (ASCVD).
• This population often meets criteria for extreme cardiovascular risk, necessitating aggressive management.
• Current management of low-density lipoprotein cholesterol (LDL-C) in this cohort is frequently suboptimal.

Purpose of the Study:

• To highlight the critical gap between current clinical practice and updated guideline recommendations for managing cardiovascular risk in people with HIV.
• To emphasize the need for improved strategies to achieve lipid targets and reduce ASCVD events in this high-risk group.

Main Methods:

• Review of current clinical guidelines for ASCVD risk management.
• Analysis of real-world data on LDL-C target achievement in people with HIV and ASCVD.
• Identification of barriers to optimal lipid management.

Main Results:

• A substantial proportion of people with HIV and ASCVD do not achieve recommended LDL-C targets.
• Suboptimal LDL-C control is a significant barrier to secondary ASCVD prevention in this population.
• There is a marked gap between guideline recommendations and actual clinical practice.

Conclusions:

• Urgent interventions are required to bridge the gap between guideline recommendations and real-world practice for managing cardiovascular risk in people with HIV.
• Improving LDL-C target achievement is crucial for reducing recurrent ASCVD events in this vulnerable population.
• Enhanced clinical strategies are essential for optimizing secondary prevention in HIV-infected individuals with established ASCVD.