Themed Poster Abstracts

Background: People living with HIV (PLWH) are at an increased risk of developing cardiovascular disease (CVD) compared to HIV negative individuals.Recent evidence shows that statins can significantly reduce the risk of developing CVD in PLWH and rapid guidance from the British HIV Association now recommends all PLWH >40 years should be offered a statin for primary prevention of CVD.We sought to evaluate the adherence to statins and other medications for CVD in PLWH and identify predictors of nonadherence to lipid-lowering agents.Method: We conducted a cross-sectional study at University Hospitals of Leicester NHS Trust between 16/04/2019 to 08/11/2022.We recruited consecutive PLWH, attending a routine follow-up appointment and who were prescribed at least one medication for CVD.We used LC-MS to assess if their prescribed medications (anti-hypertensives, diuretics, beta-blockers, lipid-lowering agents, antiplatelets, anti-coagulants, anti-diabetics) were present in the participants' urine sample.Univariable models were used to identify demographic or clinical features that were associated with non-adherence to lipid-lowering agents.Results: A total of 99 participants had urine samples analysed.Median age of participants was 54 (IQR49-60) years, 63% were male, 53% were Black and 33% were White.The majority had an undetectable HIV viral load (97/99) and were therefore presumed to be adherent to their anti-retroviral (ARV) medication.Figure 1 summarises adherence rates to medications by drug class.In one third of patients (32/99), at least one prescribed medication of interest was not detected in urine.On univariable logistic regression the number of medications prescribed for CVD was a significant predicator of non-adherence to lipid-lowering agents (per one medication increase OR 1.57 95%CI[1.03-2.43]).Conclusion: We found poor adherence to lipid-lowering agents compared to ART in PLWH.To maximise the effectiveness of statins in PLWH, careful considerations should be made to improve medication adherence,