Estimated major adverse cardiovascular events averted among persons with HIV if treated with a moderate-intensity statin.

OBJECTIVE: To estimate 10-year atherosclerotic cardiovascular disease (ASCVD) risk among US adults with diagnosed HIV (PWH) and number of first major adverse cardiovascular events (MACE) that are potentially preventable over a 5-year period, if US Department of Health and Human Services recommendations for statin therapy for PWH were fully implemented. DESIGN: Cross-sectional study of nationally representative, individual-level data on behavioral and clinical characteristics of US PWH. METHODS: Using data from standardized questionnaires and medical records abstraction collected from June 2022 to May 2023, we calculated weighted estimates of the following among PWH aged 40-75 years without documented cardiovascular disease ( N  = 2155): 10-year ASCVD risk; statin prescription by risk level; number potentially avoidable first MACE over 5 years with moderate-intensity statin treatment. We used the 2013 Pooled Cohort Equation to calculate ASCVD risk. MACE averted was estimated by applying the 5-year number needed to treat, from the REPRIEVE trial North American cohort, to the weighted number of PWH eligible for statin therapy. RESULTS: Among PWH eligible for therapy, 72.5% were male individuals, 42.5% were aged 50-59 years and 35.9% were Black, non-Hispanic persons. The overall median risk score was 7.1% [95% confidence interval (CI): 6.8-7.4%]. Among those with low (<5%) and moderate risk (5 to <20%), 19.8% (16.7-22.9%) and 36.9% (33.4-40.4%) were on statin therapy, respectively. An estimated 7418 (95% CI: 1116 -13 909) additional first MACE could be prevented over 5 years if eligible PWH received moderate-intensity statin therapy. CONCLUSION: Fully implementing statin therapy recommendations for PWH in the United States could substantially reduce MACE among this population.