Effectiveness of statins in people living with HIV: a systematic review and meta-analysis of randomized controlled trials

Abstract

ABSTRACT Introduction People living with HIV (PLWH) receiving statin therapy have shown improved lipid profiles. However, they are not free from side effects, thereby requiring strict monitoring of the therapy. The meta-analysis aims to analyze the effect of statins in PLWH and critically appraise the effectiveness of statin therapy in PLWH. Methods PubMed, Scopus, and Web of Science servers were used to conduct a systematic search in compliance with the PRISMA guidelines. The meta-analysis of pooled effect estimates is produced using Revman software. Results A total of 12 RCTs with 8716 participants were included in the analysis. Analysis of the overall effect estimates found that statins resulted in a mean reduction of 41.15 mg/dl (MD = −41.15; 95% CI: −44.19, −38.11; p < 0.00001), 34.99 mg/dl (MD = −34.99; 95% CI: −34.99; 95% CI: −41.16, −28.82; p < 0.00001), and 7.36 mg/dl (MD = −7.36; 95% CI = −48.35, −33.62; p < 0.00001) in total cholesterol, low-density lipoprotein, and triglyceride levels, respectively. It is revealed that statins are associated with a significant increase in the discontinuation rate of treatment compared to placebo treatment (RR: 1.90; 95% CI: 1.36–2.65; p = 0.0002). Conclusion When considered collectively, statin therapy’s advantages appear to exceed its occasional predictable side effects like liver or muscle toxicity. Registration PROSPERO registration ID: CRD42023469521.