Panel recommends statins for adults with HIV at risk for cardiovascular disease

In February 2024, the U.S. Division of Well being and Human Companies Panel for the Use of Antiretroviral Brokers in Adults and Adolescents with HIV (ARV Pointers Panel), in collaboration with the American Faculty of Cardiology (ACC), the American Coronary heart Affiliation (AHA), and the HIV Drugs Affiliation (HIVMA), developed statin remedy suggestions for folks with HIV (PWH).

These suggestions have been knowledgeable by the outcomes of the REPRIEVE (Randomized Trial to Stop Vascular Occasions in HIV) examine. A abstract of the suggestions related to physicians is printed in Annals of Inside Drugs.

PWH are extra in danger for a lot of aging-related illnesses, together with atherosclerotic heart problems (ASCVD). The REPRIEVE examine was a Part III, international, randomized managed trial of oral pitavastatin versus placebo for the prevention of ASCVD in PWH aged 40 to 75 years at low to intermediate danger primarily based on 10-year danger estimates.

In contrast with placebo, pitavastatin was related to a 36% discount in MACE. These findings knowledgeable the ARV panel to suggest moderate-intensity statin remedy as the first prevention amongst PWH aged 40 to 75 years with low to intermediate 10-year ASCVD danger.

The panel additionally strongly recommends initiating statin remedy amongst folks with a 10-year ASCVD danger rating of 5% or greater.

For PWH with a 10-year ASCVD danger rating beneath 5%, the panel favored statin remedy but additionally beneficial that affected person–clinician danger discussions contemplate HIV-related components than can enhance ASCVD danger.

Amongst PWH youthful than 40 years, selections to provoke statin remedy ought to be individualized and primarily based on danger components and familial well being historical past. The panel recommends using at the least moderate-intensity statins, together with pitavastatin, 4 mg each day; atorvastatin, 20 mg each day; or rosuvastatin, 10 mg each day.

The authors observe that future analysis is required to raised perceive absolutely the danger for ASCVD and different nonischemic CVD manifestations in folks with HIV.