New Statin Therapy Guidelines for HIV Positive Adults Taking Antiretrovirals

Although antiretroviral therapy (ART) allows HIV patients to live nearly as long as patients without HIV, cardiovascular disease (CVD) and cancer contribute to the mortality gap. In fact, people with HIV are twice as likely to die from CVD when compared to someone without HIV. Their age at CVD diagnosis is also on average a decade younger, according to research published in Lancet Diabetes Endocrinol.

To address this gap, the Panel for the Use of Antiretroviral Agents in Adults and Adolescents with HIV and the U.S. Department of Health and Human Services has teamed up with representatives from the American College of Cardiology, American Heart Association and the HIV Medicine Association to set new recommendations for HIV patients taking ART at risk for atherosclerotic cardiovascular disease (ACSVD).

Recommendations are based on the results of a recent REPRIEVE trial, a large randomized controlled trial of people with HIV who were aged 40 to 75 years.

For HIV patients ages 40-75 who have a low to intermediate risk for 10-year ACSVD, the new recommended treatment doses are:

• pitavastatin 4 mg once daily (AI)
• atorvastatin 20 mg once daily (AII)
• rosuvastatin 10 mg once daily (AII)

There are currently no formal recommendations for HIV patients with a ASCVD risk 20% or lower.

In the general population, people ages 20-75 who have low-density lipoprotein cholesterol, and people ages 40-75 with high ACSVD risk should begin high intensity statin therapy immediately.