Abstract
Background:Little is known about the use of statin for cardiovascular disease (CVD) risk reduction among HIV-infected patients on protease inhibitors (PI`s) in sub-Saharan Africa (SSA).Objective:Cholesterol screening and statin use were retrospectively assessed among HIV-infected participants on PI`s between 2008 and 2012 at a large urban HIV clinic in Botswana.Methods:Proportion of participants screened per year was calculated and statin indication was assessed using atherosclerosis CVD (ASCVD) and Framingham risk (FRS) scores as of the year 2012 guidelines.Results:Cholesterol screening ranged between 19% and 30% per year (2008-2011) but increased to 80% after study enrollment. The rate of hypercholesterolemia (> 5.0 mmol/L) was 31% in 2012. Fewer than 1% participants were on statin therapy but 14.3% and 9.4% had statins indicated by ASCVD and FRS respectively.Conclusion:The high proportion of participants indicated for, but not prescribed statins highlights a substantial gap in the care to reduce CVD risk among these patients.
Highlights
Little is known about the use of statin for cardiovascular disease (CVD) risk reduction among Human Immune-Deficiency Virus (HIV)-infected patients on protease inhibitors (PIs) in sub-Saharan Africa (SSA)
Fewer than 1% participants were on statin therapy but 14.3% and 9.4% had statins indicated by atherosclerosis CVD (ASCVD) and Framingham risk (FRS) respectively
The high proportion of participants indicated for, but not prescribed statins highlights a substantial gap in the care to reduce CVD risk among these patients
Summary
Little is known about the use of statin for cardiovascular disease (CVD) risk reduction among HIV-infected patients on protease inhibitors (PIs) in sub-Saharan Africa (SSA). HIV-infected patients on ritonavir boosted protease inhibitor (PI) containing antiretroviral therapy (ART) are at an increased risk for elevated cholesterol. This association is the strongest among those on first generation PIs such as ritonavir boosted lopinavir (LOP/r) [1], which is the preferred second line PI in the Botswana HIV treatment guidelines [2]. It is important to recognize and address reversible CVD risk factors such as hypercholesterolemia because HIVinfection is associated with excess risk for CVD after controlling for traditional CVD risk factors [3, 4] Despite this established association between CVD risk and HIV-infection, adherence to CVD risk factor screening is often low among HIV providers in high resource settings [5]. Whether cholesterol lowering and/or statin therapy is associated with decrease in CVD events among HIV-infected patients is unknown. Since the results are pending from REPRIEVE, major guidelines on HIV care recommend screening for cholesterol and treating hypercholesterolemia with statins [6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
