There was a time when a HIV diagnosis was considered a death sentence. But with the advent of antiretroviral therapy, people living with the HIV virus — including over 39.9 million individuals worldwide — can now lead longer, healthier lives.
Still, living with HIV comes with ongoing risks. People Living With HIV (PWH) face a much higher risk to develop cardiovascular disease — including heart attacks and strokes — and often experience these conditions nearly a decade earlier than those without HIV.
A significant clinical guideline has been developed by leading U.S. health authorities, providing crucial guidance for health care professionals on the use of statins to prevent heart disease in PWH. Among the distinguished authors of the clinical guideline is Dr Salim Virani, Vice Provost Research at Aga Khan University, whose expertise was integral to the synopsis’ development and release.
Published in the Annals of Internal Medicine, a major scientific journal, the clinical guideline aims to support clinicians in making informed decisions to better protect their patients from Atherosclerotic Cardiovascular Disease (ASCVD) - a condition caused by plaque buildup in the arteries, which can restrict blood flow and lead to serious events such as heart attacks, strokes, and peripheral artery disease. Statins have been shown to reduce ASCVD by lowering cholesterol and reducing inflammation.
“These guidelines provide the rationale and guidance on how statin therapy can be used to reduce the risk of heart attacks and strokes in people living with HIV, says Dr Virani. “With an improvement in treatment for HIV and as a result, lifespan in people living with HIV; it has become even more important to address the risk of heart attack and stroke in them.”
The clinical guideline draws from recommendations developed by the U.S. Department of Health and Human Services Panel for the Use of Antiretroviral Agents in Adults and Adolescents with HIV (ARV Guidelines Panel), working with the American College of Cardiology (ACC), the American Heart Association (AHA), and the HIV Medicine Association (HIVMA). These recommendations were heavily influenced by the findings of the recently published Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) study. REPRIEVE is a major clinical trial that provided strong evidence for using a statin called pitavastatin as a preventative treatment for ASCVD in individuals with HIV.
Importantly, the clinical guideline emphasizes how these HIV-specific guidelines complement the broader 2018 cholesterol guidelines for the general population, addressing the distinct and increased cardiovascular risks faced by PWH. It also highlights persistent gaps in primary prevention and calls for greater clinical awareness.
