Abstract
Background: Studies have consistently demonstrated that statin therapy reduces CHD-related mortality, but HIVinfected individuals are frequently undertreated for hyperlipidemia. Therefore, we sought to: 1. determine whether the numbers of patients recommended for statin therapy differed using the 2004 and 2013 guidelines; 2. evaluate the proportion of recommended patients who were actually receiving statins; and 3. evaluate the factors associated with statin prescription. Methods: Conducted cross-sectional analysis of a retrospective cohort. 100 patients receiving care at an academic inner-city HIV clinic in 2008 were reviewed. The atherosclerotic vascular disease (ASCVD) risk score was calculated using the 2013 Pooled Cohort Equation and the 2004 and 2013 guidelines were applied to evaluate numbers of patients recommended for statin therapy. Proportions were used to report patients receiving statins among those who were recommended for treatment and several unadjusted logistic regression analyses were performed to identify factors associated with utilization of statins in recommended patients. Results: 81 participants were included in the final analysis. Substantially larger numbers of HIV-infected individuals were recommended to receive statin therapy for CHD risk reduction when applying the 2013 guidelines compared to the 2004 guidelines, but less than half received statins for primary prevention as recommended. Prescription of statins was not associated with either ASCVD risk score or many traditional CHD risk factors. Diabetes mellitus was associated with increased odds of receiving statin therapy whereas hepatitis C co-infection and current smoking status were associated with decreased odds of receiving statins. Conclusions: There is an increased, large and unmet need to increase statin use for prevention of CHD. Underutilization of statins was most pronounced among HIV-hepatitis C co-infected patients and HIV-infected smokers.
Highlights
Coronary heart disease (CHD) represents a major cause of death in HIV-infected patients [1,2,3,4,5,6]
We reviewed the medical records of 100 HIV-infected patients treated at the Evelyn Jordan Center (EJC), a large inner city HIV clinic associated with the University of Maryland Medical Center (UMMC)
We found that substantially larger numbers of HIVinfected individuals were recommended to receive statin therapy for CHD risk reduction when applying the 2013 ACC/AHA guidelines for treatment of cholesterol compared to the 2004 National Cholesterol Education Program (NCEP) ATP III guidelines
Summary
Coronary heart disease (CHD) represents a major cause of death in HIV-infected patients [1,2,3,4,5,6]. HIV-infected patients often have abnormal lipid metabolism, hypertriglyceridemia and decreased high-density lipoprotein cholesterol (HDL-c) levels due to HIV infection itself and the use of ART, protease inhibitors [13,14,15,16,17,18,19]. For this reason, the Infectious Disease Society of America recommends screening for dyslipidemia prior to initiating ART and three to six months after starting therapy and at least annually thereafter [20]. We sought to: 1. determine whether the numbers of patients recommended for statin therapy differed using the 2004 and 2013 guidelines; 2. evaluate the proportion of recommended patients who were receiving statins; and 3. evaluate the factors associated with statin prescription
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.
