Comparative safety and efficacy of statins for primary prevention in human immunodeficiency virus-positive patients: a systematic review and meta-analysis
Authors' conclusion
Statin therapy significantly lowers plasma TC and LDL levels in HIV-positive patients and is associated with low rates of adverse events.
Study context
- Population
- Human immunodeficiency virus (HIV)-positive patients receiving combination antiretroviral therapy (cART), treated with statins for primary prevention (21.0% women, median age 44.1 years)
- Participants
- 736 patients · 18 studies
- Comparison
- Different statins in HIV-positive patients on cART
- Outcome
- Effect of statin therapy on total cholesterol (TC) levels
Methodological detailsmeta-regression
- Meta-regression
Pooled result
As reported in the abstract
Change in TC (largest reductions)
Rosuvastatin 10 mg
−1.67
mean · 95% CI −1.99–-1.35 · mmol/L
Atorvastatin 10 mg
−1.44
mean · 95% CI −1.85–-1.02 · mmol/L
Further pooled results
| Outcome | Values |
|---|---|
| Change in LDL (largest reductions) | Atorvastatin 80 mg mean −2.10 (95% CI −3.39–-0.81) mmol/L · Simvastatin 20 mg mean −1.57 (95% CI −2.67–-0.47) mmol/L |
| Change in HDL (largest increases) | Pravastatin 10-20 mg mean 0.24 (95% CI 0.10–0.38) mmol/L · Atorvastatin 10 mg mean 0.15 (95% CI 0.007–0.23) mmol/L |
| Change in TG (largest reductions) | Atorvastatin 80 mg mean −0.60 (95% CI −1.09–-0.11) mmol/L · Simvastatin 20 mg mean −0.61 (95% CI −1.14–-0.08) mmol/L |
Meta-regression: Total cholesterol (TC) lowering
- Nucleoside reverse transcriptase inhibitor-sparing regimens associated with reduced statin efficacy for lowering TC
Safety
| Outcome | Values |
|---|---|
| Discontinuation rate | Atorvastatin 10 mg 26.5 (95% CI −13.4–64.7) per 100 person-years |
- Discontinuation rate — Mean discontinuation rate, all statins
- 0.12 (per 100 person-years; 95% CI 0.05, 0.20)
Original publication
Comparative safety and efficacy of statins for primary prevention in human immunodeficiency virus-positive patients: a systematic review and meta-analysis. Eur Heart J. Published 6 February 2016. doi:10.
Summarised from the published abstract; every number is checked against it