Influence of Statin Therapy on the Incidence of Cardiovascular Events, Cancer, and All-Cause Mortality in People Living With HIV: A Meta-Analysis

Li, Yanping; Wang, Zhandi; Xia, Haimei; Ju, Zhang

doi:10.3389/fmed.2021.769740

Cited by 4 publications

(3 citation statements)

References 45 publications

(121 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Li and colleagues in a recent meta-analysis of 9 cohort studies involving 73, 256 participants found that statins were associated with a 44% reduction in all-cause mortality [40]. Additionally, another metaanalytic pooling of 7 cohort studies with 35,708 participants showed that statins decrease all-cause mortality by 33% in PLWH with/without HAART [41].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and Safety of Statins on Outcomes in Patients with HIV Infection: A Systematic Review and Meta-Analysis

Vigny

Bonsu

Kadirvelu

2022

Preprint

View full text Add to dashboard Cite

Statins are hypolipidaemic in human immunodeficiency virus (HIV) positive individuals. However, their all-cause mortality and discontinuation rates improvement is unclear. We evaluated statins impact on all-cause mortality, discontinuation rates, and adverse effects incidence among HIV patients on highly active antiretroviral therapy (HAART). We searched four electronic databases from inception until October 2021 for trials and cohort studies in HIV patients evaluating statins versus placebo. Forty-seven studies involving 91,594 patients were included. Statins significantly decreased discontinuation rates (RR, 0.701; 95% CI, 0.508–0.967; p = 0.031), but insignificantly reduced all-cause mortality (RR, 0.994; 95% CI, 0.561–1.588; p = 0.827). Also, statins insignificantly lowered the incidence of any adverse effects (RR, 0.780; 95% CI, 0.564–1.077; p = 0.131), diabetes mellitus (RR, 0.272; 95% CI, 0.031–2.393; p = 0.241) and raised the incidence of myalgia (RR, 1.341; 95% CI, 0.770–2.333; p = 0.299), and elevated creatine kinase (RR, 1.101; 95% CI, 0.457–2.651; p = 0.830) and liver enzyme (RR, 1.709; 95% CI, 0.605–4.831; p = 0.312) activities. In HAART-experienced patients, statins reduced discontinuation rates and had comparable effects on all-cause mortality with placebo. Furthermore, statin therapy did not increase the onset of any adverse effects, myalgia, elevated creatine kinase and liver enzyme activities, and decrease the onset of diabetes mellitus.

show abstract

Section: Discussionmentioning

confidence: 99%

Effectiveness and Safety of Statins on Outcomes in Patients with HIV Infection: A Systematic Review and Meta-Analysis

Vigny

Bonsu

Kadirvelu

2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Notably, the Johns Hopkins HIV clinical cohort that enrolled 1538 virally suppressed HIV individuals under statin treatment demonstrated a reduced risk of all-cause mortality after adjusting for CD4 count, HIV-1 RNA, hemoglobin, and cholesterol levels at the start of HAART, age, race, HIV risk group, prior use of ART, year of HAART start, NNRTI versus PI-based ART, prior AIDS-defining illness, and viral hepatitis coinfection [156]. The aforementioned data are strengthened by a recent meta-analysis of 36,253 HIV individuals undergoing statin treatment, where statin use was independently statistically correlated with a reduced mortality risk in PLWH [147].…”

Section: Statinsmentioning

confidence: 99%

Pathophysiology and Clinical Management of Dyslipidemia in People Living with HIV: Sailing through Rough Seas

Papantoniou,

Arvanitakis,

Markakis

et al. 2024

Life

View full text Add to dashboard Cite

Infections with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) represent one of the greatest health burdens worldwide. The complex pathophysiological pathways that link highly active antiretroviral therapy (HAART) and HIV infection per se with dyslipidemia make the management of lipid disorders and the subsequent increase in cardiovascular risk essential for the treatment of people living with HIV (PLHIV). Amongst HAART regimens, darunavir and atazanavir, tenofovir disoproxil fumarate, nevirapine, rilpivirine, and especially integrase inhibitors have demonstrated the most favorable lipid profile, emerging as sustainable options in HAART substitution. To this day, statins remain the cornerstone pharmacotherapy for dyslipidemia in PLHIV, although important drug–drug interactions with different HAART agents should be taken into account upon treatment initiation. For those intolerant or not meeting therapeutic goals, the addition of ezetimibe, PCSK9, bempedoic acid, fibrates, or fish oils should also be considered. This review summarizes the current literature on the multifactorial etiology and intricate pathophysiology of hyperlipidemia in PLHIV, with an emphasis on the role of different HAART agents, while also providing valuable insights into potential switching strategies and therapeutic options.

show abstract

“…Lipid disorders are more prevalent among HIV-infected patients whether they are taking ART medications or not. Understanding these dyslipidemias is important to screen or diagnose the cause of lipid disorder, which may lead to life-threatening cardiovascular diseases and will improve the treatment outcomes in HIV-infected patients, thus providing a better quality of life [14].…”

Section: Introductionmentioning

confidence: 99%

Spectrum of Dyslipidemias in Treatment-Naïve Human Immunodeficiency Virus-Infected Patients Presenting to an HIV Clinic of a Tertiary Care Hospital

Iqbal¹,

Salman²,

Akhtar³

et al. 2022

Cureus

View full text Add to dashboard Cite

IntroductionHIV/AIDS is a major communicable disease worldwide, especially in developing countries where disease prevalence is over 90%. The National AIDS Control Programme of Pakistan reported around 160,000 HIV cases (140,000) with a 5% prevalence among traditional risks groups. HIV infection is thought to affect lipids metabolism adversely, thus resulting in increased morbidity and mortality. The aim of the study was to find out the frequency and types of dyslipidemia in patients with HIV not taking anti-retroviral therapy, presenting to an HIV clinic at a tertiary care hospital. MethodsThis cross-sectional study was conducted at the HIV clinic of Jinnah Hospital from January 2020 to July 2020. A total of 280 treatment-naïve patients, fulfilling the inclusion protocol, were included through nonprobability consecutive sampling after informed consent. Blood samples of 5 mL were taken using aseptic measures and following standard procedure after ensuring overnight fasting by a nurse and were sent immediately to the pathology laboratory of Allama Iqbal Medical College. The results of the lipid profile were collected the next day and noted in the proforma. Dyslipidemia and type of dyslipidemia were recorded as per operational definition. Data were analyzed by SPSS software, version 27.0 (IBM Corp., Armonk, NY). Cross-tabulation was done to assess the relationship of gender, BMI, and family history on dyslipidemia, and a chi-square test was applied to check statistical significance. ResultsAmong 280 treatment-naïve HIV-infected patients, the majority of patients were females (52%). The mean duration of HIV was 9.31 + 2.13 months. About 55% of patients had a BMI of more than 25 kg m 2 . A family history of dyslipidemia was found in 62% of the patients. Dyslipidemia was observed in 70% of patients with maximum derangement seen in total cholesterol level (62%). After applying the chi-square test, a significant relation was identified between BMI and family history with dyslipidemia in HIV-infected individuals (pvalue = 0.00). ConclusionA considerable proportion of treatment-naïve HIV patients have underlying dyslipidemia with a significant relationship with higher BMI and a family history of dyslipidemia. The findings of this study highlight the importance of early screening for dyslipidemia in HIV patients.

show abstract

Influence of Statin Therapy on the Incidence of Cardiovascular Events, Cancer, and All-Cause Mortality in People Living With HIV: A Meta-Analysis

Cited by 4 publications

References 45 publications

Effectiveness and Safety of Statins on Outcomes in Patients with HIV Infection: A Systematic Review and Meta-Analysis

Effectiveness and Safety of Statins on Outcomes in Patients with HIV Infection: A Systematic Review and Meta-Analysis

Pathophysiology and Clinical Management of Dyslipidemia in People Living with HIV: Sailing through Rough Seas

Spectrum of Dyslipidemias in Treatment-Naïve Human Immunodeficiency Virus-Infected Patients Presenting to an HIV Clinic of a Tertiary Care Hospital

Contact Info

Product

Resources

About