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Estimated major adverse cardiovascular events averted among persons with HIV if treated with a moderate-intensity statin.

Kathy K. Byrd,Y. Tie,Carol Lin,Yishiow Kuo,Linda Beer,Siobhán M O'Connor,Kate Buchacz,Feijun Luo,John Weiser

Published 2025 in AIDS (London)

ABSTRACT

OBJECTIVE To estimate 10-year atherosclerotic cardiovascular disease (ASCVD) risk among U.S. adults with diagnosed HIV (PWH) and number of first major adverse cardiovascular events (MACE) that are potentially preventable over a 5-year period, if U.S. Department of Health and Human Services recommendations for statin therapy for PWH were fully implemented. DESIGN Cross-sectional study of nationally representative, individual-level data on behavioral and clinical characteristics of U.S. PWH. METHODS Using data from standardized questionnaires and medical records abstraction collected from June 2022-May 2023, we calculated weighted estimates of the following among PWH aged 40-75 years without documented cardiovascular disease (N = 2,155): 10-year ASCVD risk; statin prescription by risk level; number potentially avoidable first MACE over 5 years with moderate-intensity statin treatment. We used the 2013 Pooled Cohort Equation to calculate ASCVD risk. MACE averted was estimated by applying a previously published 5-year number needed to treat to the weighted number of PWH eligible for statin therapy. RESULTS Among PWH eligible for therapy, 72.5% were male, 42.5% were aged 50-59 years and 35.9% were Black, non-Hispanic persons. The overall median risk score was 7.1% (95% Confidence Interval [CI]: 6.8%-7.4%). Among those with low (<5%) and moderate risk (5%-<20%), 19.8% (16.7%-22.9%) and 36.9% (33.4%-40.4%) were on statin therapy, respectively. An estimated 7,418 (95% CI: 1,116 -13,909) additional first MACE could be prevented over 5 years if eligible PWH received moderate-intensity statin therapy. CONCLUSIONS Fully implementing statin therapy recommendations for PWH in the United States could substantially reduce MACE among this population.

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