Statins Are Underprescribed, Prescribed at Lower Intensities in Patients With HIV

Individuals with HIV have an increased risk for atherosclerotic cardiovascular disease (ASCVD). However, findings of a new review¹ presented at IDWeek 2019 show that individuals with HIV are not receiving adequate-intensity statins to prevent ASCVD.

There are no current guidelines for prescribing statins specifically for patients with HIV; the current guidelines² cite a lack of representation of patients with HIV in randomized clinical trials, and therefore, the writing panel could not make any definitive recommendations.

In this new review, the researchers analyzed whether eligible patients receive the correct statin intensity compared with uninfected controls. To do so, the researchers recruited 300 patients aged 40 to 75 years who presented at an HIV clinic and an internal medicine clinic at an urban, academic medical center from June 2018 to September 2018.

To be included in the analysis, patients had to meet eligibility criteria for statins based on the 2013 American College of Cardiology/American Heart Association Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults,² as well as have a lipid panel within the last year.

Overall, 221 participants were eligible to receive statin therapy. Although many eligible participants were receiving statin therapy, only about 31% were on the correct statin intensity.

Participants with HIV and women were less likely to be prescribed the correct statin intensity and were more likely to have polypharmacy and hypertension.

“This study reveals that [people living with HIV] may be at a substantial disadvantage in terms of receiving correct statin therapy for ASCVD risk reduction,” the researchers concluded. “This finding may be particularly important given the heightened risk for ASCVD in this patient population.”

—Amanda Balbi

References:

1. Schafer J, Patel R, Hastain N, Miano T. Patients living with HIV infection are less likely to receive the correct intensity of statin therapy for cardiovascular disease risk reduction. Paper presented at: IDWeek 2019; October 2-6, 2019: Washington, DC. https://www.eventscribe.com/2019/IDWeek/fsPopup.asp?Mode=posterinfo&PosterID=230420.
2. Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25, Suppl 2). https://doi.org/10.1161/01.cir.0000437738.63853.7a.