Statin use and LDL cholesterol target attainment in people with HIV after European AIDS Clinical Society 2024...

Area of Science:

• Cardiology
• Infectious Diseases
• Pharmacology

Background:

• The 2024 European AIDS Clinical Society (EACS) guidelines recommend stricter low-density lipoprotein cholesterol (LDL-C) targets for people with HIV (PWH).
• Effective lipid management is crucial for reducing cardiovascular risk in PWH, a population with elevated risk.
• Assessing the impact of updated guidelines on clinical practice is essential for improving patient outcomes.

Purpose of the Study:

• To evaluate the changes in statin prescription patterns among people with HIV (PWH) following the implementation of the 2024 EACS guidelines.
• To assess the attainment of new, stricter LDL-C targets in PWH after the guideline update.
• To identify factors influencing statin prescription and LDL-C target achievement in PWH.

Main Methods:

• A retrospective, single-center study design was employed.
• Data were collected from people with HIV (PWH) aged 40 years and older during two periods: April 2023-April 2024 (pre-update) and April 2024-April 2025 (post-update).
• Lipid-lowering therapy use, LDL-C levels, and attainment of 2024 EACS criteria were analyzed.

Main Results:

• Statin use significantly increased from 38% to 49% after the guideline update (aOR 1.47).
• Combination therapy with statins and ezetimibe also saw a rise (9% to 19%).
• Despite increased statin use, LDL-C target attainment remained low (8% vs 10%), with individuals of African and Hispanic origin showing lower odds of receiving statins compared to Caucasians.

Conclusions:

• The 2024 EACS guideline update led to increased statin prescription for people with HIV (PWH).
• However, low LDL-C target attainment persists, indicating incomplete implementation of recommended lipid management strategies.
• Disparities in statin prescription based on ethnicity were observed, warranting further investigation and targeted interventions.