Persons with human immunodeficiency virus (HIV) infection have up to two times the risk of cardiovascular disease as those without HIV infection.1 This risk is not explained by the presence of risk factors for atherosclerotic cardiovascular disease, nor is it eliminated by successful antiretroviral therapy and viral suppression.2 Assessing cardiovascular risk among persons with HIV infection has proved to be difficult because calculators for cardiovascular disease typically underestimate the risk in this population.3 This underestimation creates a challenge for health care providers. How can cardiovascular risk be reduced in a population that is assessed as being at low-to-moderate risk on the basis of a traditional disease calculator? Presently, there are no cardiovascular disease prevention guidelines that are specific to this population. Grinspoon et al.4 now report the results of pitavastatin therapy in the phase 3 Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) involving persons with HIV infection who had a low-to-moderate risk of atherosclerotic cardiovascular disease, as determined by the American Heart Association and the American College of Cardiology Pooled Cohort Equation risk calculator and specific thresholds for low-density lipoprotein (LDL) cholesterol. All the participants were between the ages of 40 and 75 years and were receiving antiretroviral therapy, with a CD4 count of more than 100 cells per cubic millimeter.
展开▼
