everyone over 40 with HIV should be offered statins, irrespective of whether they show a raised cholesterol level in their blood.It’s basing its new recommendations on the large REPRIEVE study, the largest randomized trial undertaken in people living with HIV.
Part of the study compared participants assigned a statin against those given a placebo. Those on statins were significantly less likely to develop major cardiovascular problems.“We recommend that all people living with HIV aged 40 years or older should be offered a statin for primary prevention of CVD irrespective of lipid profile or estimated CVD risk,” says the report.It highlights the FDA-approved moderate-intensity pitavastatin as the medication of choice but suggests atorvastatin as an alternative.
In the UK, pitavastatin is not yet available throught the national health service due to its cost. Ezetimibe can be prescribed for people who don’t react well to statins.BHIVA also stresses that any use of statins should be combined with a wider, holistic approach.
This includes good nutrition and advice about smoking and alcohol. Cigarettes, heavy drinking and obesity remain major risk factors when it comes to heart disease.