Since the publication of the REPRIEVE trial last summer in The New England Journal of Medicine, there has been renewed interest and enthusiasm for cardiovascular disease (CVD) prevention for people living with HIV (PLWH). Regardless of how you feel about the benefits of statins, we can all agree that helping our patients live long and healthy lives requires us to look beyond the HIV care cascade to consider the prevention of non-AIDS comorbidities, including CVD.
Taking a whole health approach requires us to continually reexamine how we provide care in our HIV clinics and consider how we can do better to address the top 3 risk factors for heart disease in PLWH: smoking, hypertension, and high cholesterol. It is encouraging to see smoking rates among PLWH decline in many places. Where smoking is still common, smoking cessation programs are needed urgently, but advice about smoking cessation for PLWH is beyond the scope of this review. Instead, this review focuses on new (and old) strategies to address hypertension and cholesterol. Statins are certainly our mainstay of CVD prevention, but we now have a range of new evidence-based options to treat residual lipid, metabolic, and inflammatory risk. If properly implemented in HIV clinics, we might achieve health outcomes for our patients that rival or even surpass those of the general population.
Read the full review here.
Source : Infectious Disease Special Edition
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