Key result
Statins show potential for primary cardiovascular disease prevention in people living with HIV by targeting both traditional and HIV-specific risk factors, with definitive efficacy data pending from the ongoing REPRIEVE trial.
Why the study?
People with HIV face an increased risk of cardiovascular disease driven by traditional and HIV-specific risk factors, but data exploring statin therapy for primary cardiovascular prevention in this population are limited.
Do statins prevent cardiovascular disease in people with HIV?
Do statins prevent cardiovascular disease in people with HIV?
Statins show potential for primary cardiovascular disease prevention in people with HIV by lowering cholesterol and stabilizing plaques, though definitive clinical outcome data from trials like REPRIEVE are pending.
PURPOSE OF REVIEW: While people with HIV (PWH) are living longer due to advances in antiretroviral therapy, recent data have demonstrated an increased risk of cardiovascular disease (CVD) among this population. This increased risk is thought to be due to both traditional (for example, smoking, diabetes) and HIV-specific (for example, inflammation, persistent immune activation) risk factors. This review focuses on the potential for statin therapy to mitigate this increased risk. RECENT FINDINGS: Several randomized clinical trials have demonstrated that statins, a class of lipid-lowering medications, are effective as a primary CVD prevention strategy among people without HIV. Among PWH, statins have been shown to lower cholesterol, exert immunomodulatory effects, stabilize coronary atherosclerotic plaque, and even induce plaque regression. SUMMARY: Prevention of CVD among the aging population of people with controlled, but chronic, HIV is vital. Data exploring primary prevention in this context are thus far limited. The Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) is ongoing; this trial will inform the field by investigating the effects of pitavastatin calcium as a primary prevention strategy for major adverse cardiovascular events among PWH on antiretroviral therapy (ART) at low-to-moderate traditional CVD risk.
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Fitch et al. (2022) conducted a review in HIV. Statins was evaluated. Statins show potential for primary cardiovascular disease prevention in people living with HIV by targeting both traditional and HIV-specific risk factors, with definitive efficacy data pending from the ongoing REPRIEVE trial.
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