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Statins and Aspirin use in HIV-infected people: gap between European AIDS Clinical Society guidelines and clinical practice: the results from HIV-HY study

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Abstract

Objectives

To investigate the use of statins and acetylsalicylic acid (ASA) in HIV people in clinical practice.

Design

A multicenter, nationwide, prospective cohort study, including 1182 consecutive HIV patients was conducted.

Methods

Statin and ASA prescription was evaluated in primary and secondary cardiovascular disease prevention, according to the European AIDS Clinical Society (EACS) guidelines.

Results

Followed-up patients (998) were mostly males (70.9 %) with a mean age at enrolment of 46.5 years (SD 9.5). The mean time of follow-up was 3.3 years (SD 0.8). At the last follow-up visit, statins would have been recommended for 31.2 % and ASA for 16 % by EACS guidelines. Conversely, only 15.6 and 7.6 % of patients were on statin and ASA treatment, respectively; only 50.3 % of patients treated with statins achieved recommended low-density lipoprotein cholesterol (LDL-c) levels. At the last follow-up visit, agreement between statin therapy and EACS recommendation was 0.58 (95 % CI 0.52–0.63). The corresponding figure for ASA therapy was 0.50 (95 % CI 0.42–0.58), whereas the agreement for ASA therapy in secondary prevention was 0.59 (95 % CI 0.50–0.68).

Conclusions

The prescription of statins and ASA in HIV-infected patients remains largely suboptimal, as only about 50 % of patients requiring statins and ASA are properly treated. Higher attention on this relevant issue and further investigation are warranted in this at risk population.

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Acknowledgments

The HIV-HY group comprises the following members.

Co-ordination: Giuseppe Vittorio De Socio, Elena Ricci, Giuseppe Schillaci.

Recruitment sites and investigators: Giuseppe Vittorio De Socio, Franco Baldelli (Perugia); Paolo Maggi, Chiara Bellacosa, Francesca Lenoci (Bari); Giancarlo Orofino, Marta Guastavigna (Torino); Giustino Parruti, Elena Mazzotta (Pescara); Laura Carenzi, Giuliano Rizzardini (Milano); Benedetto Maurizio Celesia, Maria Gussio, Mauro Maresca (Catania); Maria Stella Mura, Giordano Madeddu, Paola Bagella (Sassari); Giovanni Penco, Giancarlo Antonucci (Genova); Tiziana Quirino, Barbara Menzaghi (Busto Arsizio); Marco Franzetti, Stefano Rusconi (Milano); Canio Martinelli (Firenze); Antonio Di Biagio, Lucia Taramasso, Roberta Prinapori (Genova); Leonardo Calza (Bologna); Ilaria Caramma, Chiara Molteni, Paolo Bonfanti (Lecco).

Author information

Authors and Affiliations

  1. Clinica di Malattie Infettive, Azienda Ospedaliero-Universitaria di Perugia, Piazzale Menghini 1, 06129, Perugia, Italy

    Giuseppe Vittorio De Socio

  2. Department of Infectious Diseases, Luigi Sacco Hospital, Milan, Italy

    Elena Ricci & Laura Carenzi

  3. Department of Infectious Diseases, Pescara Hospital, Pescara, Italy

    Giustino Parruti

  4. Infectious Diseases Clinic, University of Bologna, Bologna, Italy

    Leonardo Calza

  5. Unit of Infectious Diseases, University of Bari, Bari, Italy

    Paolo Maggi

  6. Unit of Infectious Diseases, Garibaldi Hospital, University of Catania, Catania, Italy

    Benedetto Maurizio Celesia

  7. Department of Infectious Diseases, Amedeo di Savoia Hospital, Turin, Italy

    Giancarlo Orofino

  8. Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy

    Giordano Madeddu

  9. Department of Infectious Diseases, Careggi Hospital, Florence, Italy

    Canio Martinelli

  10. Unit of Infectious Diseases, Busto Arsizio Hospital, Busto Arsizio, Italy

    Barbara Menzaghi

  11. Infectious Diseases, Hospital University San Martino Genoa, Genoa, Italy

    Lucia Taramasso

  12. Department of Infectious Diseases, Galliera Hospital, Genoa, Italy

    Giovanni Penco

  13. Unit of Infectious Diseases, University of Milan, Milan, Italy

    Marco Franzetti

  14. Unit of Infectious Diseases, Manzoni Hospital, Lecco, Italy

    Paolo Bonfanti

Authors
  1. Giuseppe Vittorio De Socio
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  2. Elena Ricci
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  3. Giustino Parruti
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  4. Leonardo Calza
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  6. Benedetto Maurizio Celesia
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  7. Giancarlo Orofino
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  8. Giordano Madeddu
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  9. Canio Martinelli
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  10. Barbara Menzaghi
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  11. Lucia Taramasso
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  12. Giovanni Penco
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  13. Laura Carenzi
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  14. Marco Franzetti
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  15. Paolo Bonfanti
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Corresponding author

Correspondence to Giuseppe Vittorio De Socio.

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Conflict of interest

No conflict of interest in this paper.

Ethics

Patients were enrolled in the HIV-HY study as previously reported [10]. Informed consent was not required by the ethics committee, because confidentiality was guaranteed and no interventions were performed.

Funding

No funding has been provided by any private or public actor beyond the current clinical practice (National Health Service).

Additional information

The CISAI study group members are listed in Acknowledgments section.

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De Socio, G.V., Ricci, E., Parruti, G. et al. Statins and Aspirin use in HIV-infected people: gap between European AIDS Clinical Society guidelines and clinical practice: the results from HIV-HY study. Infection 44, 589–597 (2016). https://doi.org/10.1007/s15010-016-0893-z

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  • DOI: https://doi.org/10.1007/s15010-016-0893-z

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