HIV and Cardiovascular Risk: Early Statin Use May Help

Emily Newman
Original Article:

People with HIV on antiretroviral therapy (ART) with controlled viral loads may benefit from using statins earlier than typically prescribed to control high cholesterol, according to two studies presented last week at CROI 2015.

The studies provide startling evidence that people living with HIV on ART—with controlled viral loads and normal cholesterol levels—may rapidly develop coronary features linked to coronary artery disease (CAD) even before traditional clinical assessments indicate a cause for concern. In tandem with these findings, lead investigators on two separate studies reported that early daily statin use can halt the progression of these high-risk coronary features associated with CAD.

Grace McComsey, MD, from Case Western Reserve University, presented evidence that, for people with controlled viral loads on ART longer than 6 months, 10 mg per day of rosuvastatin (Crestor) halted progression of two surrogate markers of cardiovascular disease: carotid intra-media thickening (i.e., thickening of the carotid artery wall) and coronary calcification (i.e., calcium deposit build-up in arteries) (abstract 137). Both of these are linked to cardiovascular problems like heart attacks.

This randomized, placebo-controlled study included a total of 147 people on ART with viral loads under 1000 copies/mL—mostly (80%) men, with a group median age of 46. The research team measured changes in the two risk factors (intra-media thickness and coronary calcification) during the study.

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