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Studies offer mounting evidence that statins may reduce the risk of heart disease in people living with HIV
Theo Smart, 2015-03-10 08:40:00

Evidence is mounting that statin therapy can prevent the progression of coronary atherosclerosis (hardening and narrowing of the arteries supplying the heart) in people living with HIV, according to the results of two randomized clinical trials reported last week at the 2015 Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle.

In the first study, the use of atorvastatin (Lipitor) reduced the overall volume of plaque deposits in the coronary arteries in people with HIV, including the 'high risk morphology' plaques that are particularly vulnerable to acute rupture leading to heart attacks, stroke and sudden cardiac death. The second study of statin therapy in people on antiretroviral therapy found that rosuvastatin (Crestor) halted progression of carotid intima-media thickening, a surrogate marker for vascular and atherosclerotic disease.

While it has yet to be demonstrated whether these changes on statin therapy will translate into fewer cardiac events and less death among people living with HIV, statin use has been shown to reduce cardiovascular disease (CVD) and provide a survival benefit in the HIV-negative general population. However, the risk factors for CVD are somewhat different for HIV-positive people, so the question is being addressed by the REPRIEVE study, a very large multicentre clinical trial which is now getting underway.