Journal of General Internal Medicine

, Volume 24, Issue 3, pp 334–340

The Association Between the Receipt of Lipid Lowering Therapy and HIV Status Among Veterans Who Met NCEP/ATP III Criteria for the Receipt of Lipid Lowering Medication

  • Matthew S. Freiberg
  • David A. Leaf
  • Joseph L. Goulet
  • Matthew B. Goetz
  • Krisann K. Oursler
  • Cynthia L. Gibert
  • Maria C. Rodriguez-Barradas
  • Adeel A. Butt
  • Amy C. Justice
Original Article

DOI: 10.1007/s11606-008-0891-7

Cite this article as:
Freiberg, M.S., Leaf, D.A., Goulet, J.L. et al. J GEN INTERN MED (2009) 24: 334. doi:10.1007/s11606-008-0891-7

ABSTRACT

OBJECTIVE

To examine the association between HIV infection status and the receipt of lipid lowering therapy based on National Cholesterol Education Program/Adult Treatment Panel (NCEP/ATP III) guidelines and to assess whether HIV viral load and hepatitis C (HCV) status alters that association.

PARTICIPANTS AND DESIGN

A cross-sectional analysis of survey, laboratory, and pharmacy data from 1,577 male participants (59% HIV infected) of the Veterans Aging Cohort Five-Site Study, a prospective observational cohort of U.S. veterans with and without HIV infection.

MEASUREMENTS

Receipt of lipid lowering therapy obtained from the VA pharmacy benefits management system was the main outcome.

RESULTS

The prevalence of lipid lowering therapy among HIV-infected and HIV-uninfected veterans was 15.4% vs. 37.9%, respectively, p < 0.01. Among veterans who met NCEP/ATP III criteria for lipid lowering therapy, HIV-infected veterans had a significantly lower prevalence for the receipt of lipid lowering therapy (adjusted odds ratio (OR) = 0.43, 95% confidence interval (C.I.) 0.28–0.67) as compared with HIV-uninfected veterans. Among HIV-infected veterans, log HIV viral load (adjusted OR = 0.57, 95% CI, 0.41–0.81) and HIV-HCV co-infection (adjusted OR = 0.31, 95% CI = 0.13–0.75) were negatively associated with receipt of lipid lowering therapy. Exposure to HAART was not associated with receipt of lipid lowering therapy.

CONCLUSIONS

Among those who met NCEP/ATP III criteria for lipid lowering therapy, HIV-infected veterans, particularly those with high HIV viral loads and HCV co-infection, were significantly less likely to receive lipid lowering therapy. This may be a modifiable mediator of cardiovascular disease among HIV-infected individuals.

KEY WORDS

HIV cholesterol hepatitis C men veterans cardiovascular diseases 

Copyright information

© Society of General Internal Medicine 2008

Authors and Affiliations

  • Matthew S. Freiberg
    • 1
  • David A. Leaf
    • 2
  • Joseph L. Goulet
    • 3
  • Matthew B. Goetz
    • 2
  • Krisann K. Oursler
    • 4
  • Cynthia L. Gibert
    • 5
  • Maria C. Rodriguez-Barradas
    • 6
  • Adeel A. Butt
    • 7
  • Amy C. Justice
    • 3
  1. 1.University of Pittsburgh, Center for Research on Health CarePittsburghUSA
  2. 2.VA Greater Los Angeles Healthcare SystemDavid Geffen School of Medicine at UCLALos AngelesUSA
  3. 3.VA Connecticut Healthcare SystemYale University School of MedicineNew HavenUSA
  4. 4.University of Maryland School of MedicineBaltimore VA Medical CenterBaltimoreUSA
  5. 5.George Washington University Medical CenterVA Medical CenterWashingtonUSA
  6. 6.Michael E. DeBakey VA Medical CenterBaylor College of MedicineHoustonUSA
  7. 7.University of Pittsburgh School of Medicine, VA Pittsburgh Healthcare System, Center for Health Equity Research and PromotionPittsburghUSA

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