HIV

What is new?

People with HIV have a two-fold increased risk of ASCVD compared with the general population which was also acknowledged in the 2019 ESC/EAS Guidelines, which recommended that lipid-lowering therapy (mostly statins) should be considered in people with dyslipidaemia to achieve the LDL-C goal as defined for high-risk patients which was Class IIa Level C recommendation.

In 2023 the randomized placebo controlled REPRIEVE study showed that pitavastatin reduced the risk of MACE in people with HIV without ASCVD aged 40-75 with This led to the new class 1, level B, recommendation to recommend statin therapy for people in primary prevention aged ≥40 years with HIV, irrespective of estimated cardiovascular risk and LDL-C levels, to reduce the risk of cardiovascular events.

Recommendations

Recommendations	Class^a	Level^b
Statin therapy is recommended for people in primary prevention aged ≥40 years with HIV, irrespective of estimated cardiovascular risk and LDL-C levels, to reduce the risk of cardiovascular events; the choice of statin should be based on potential drug interactions.⁷	I	B

HIV, human immunodeficiency virus; LDL-C, low-density lipoprotein cholesterol.
^a Class of recommendation.
^b Level of evidence.