@article{3cd9817861b448218bd9228186fd46a9,
title = "Underutilization of Statins When Indicated in HIV-Seropositive and Seronegative Women",
abstract = "Increased life expectancy of persons living with HIV infection receiving antiretroviral therapy heightens the importance of preventing and treating chronic comorbidities such as cardiovascular disease. While guidelines have increasingly advocated more aggressive use of statins for low-density lipoprotein (LDL) cholesterol reduction, it is unclear whether people with HIV, especially women, are receiving statins when indicated, and whether their HIV disease is a factor in access. We assessed the cumulative incidence of statin use after an indication in the Women's Interagency HIV Study (WIHS), from 2000 to 2014. Additionally, we used weighted proportional hazards regression to estimate the effect of HIV serostatus on the time to initiation of a statin after an indication. Cumulative incidence of statin use 5 years after an indication was low: 38% in HIV-seropositive women and 30% in HIV-seronegative women. Compared to HIV-seronegative women, the weighted hazard ratio for initiation of a statin for HIV-seropositive women over 5 years was 0.94 [95% confidence interval (CI) 0.62, 1.43]. Applying the American College of Cardiology and the American Heart Association (ACC/AHA) guidelines increased the proportion of HIV-seropositive women with a statin indication from 16% to 45%. Clinicians treating HIV-seropositive women should consider more aggressive management of the dyslipidemia often found in this population.",
keywords = "cardiovascular disease, human immunodeficiency virus, hydroxymethylglutaryl-CoA reductase inhibitors, lipids, statins, women's health",
author = "Todd, {Jonathan V.} and Cole, {Stephen R.} and Wohl, {David A.} and Simpson, {Ross J.} and {Jonsson Funk}, Michele and Brookhart, {M. Alan} and Jennifer Cocohoba and Daniel Merenstein and Anjali Sharma and Jason Lazar and Joel Milam and Mardge Cohen and Stephen Gange and Lewis, {Ten{\'e} T.} and Greer Burkholder and Adimora, {Adaora A.}",
note = "Funding Information: Data in this article were collected by the Women{\textquoteright}s Interagency HIV Study (WIHS). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). WIHS (Principal Investigators): UAB-MS WIHS (Michael Saag, Mirjam-Colette Kempf, and Deborah Konkle-Parker), U01-AI-103401; Atlanta WIHS (Ighovwerha Ofotokun and Gina Wingood), U01-AI-103408; Bronx WIHS (Kathryn Anastos), U01-AI-035004; Brooklyn WIHS (Howard Minkoff and Deborah Gustafson), U01-AI-031834; Chicago WIHS (M.C. and Audrey French), U01-AI-034993; Metropolitan Washington WIHS (Seble Kassaye), U01-AI-034994; Miami WIHS (Margaret Fischl and Lisa Metsch), U01-AI-103397; UNC WIHS (A.A.), U01-AI-103390; Connie Wofsy Women{\textquoteright}s HIV Study, Northern California (Ruth Greenblatt, Bradley Aouizerat, and Phyllis Tien), U01-AI-034989; WIHS Data Management and Analysis Center (S.G. and Elizabeth Golub), U01-AI-042590; Southern California WIHS ( J.M.), U01-HD-032632 (WIHS I– WIHS IV). The WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute on Mental Health (NIMH). Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research (NIDCR), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Deafness and other Communication Disorders (NIDCD), and the NIH Office of Research on Women{\textquoteright}s Health. WIHS data collection is also supported by UL1-TR000004 (UCSF CTSA) and UL1-TR000454 (Atlanta CTSA). This work was supported by R01AI100654 and P30AI050410 (CFAR) from the National Institutes of Health. These grants are located in Chapel Hill, NC. Funding Information: M.J.F. is a member of the Scientific Steering Committee (SSC) for a postapproval safety study funded by Glaxo-SmithKline, and receives salary support through a contract with AstraZeneca. G.B. has research support from Amgen, Inc., Bristol-Myers Squibb, and has consulted for Definicare, LLC. All other authors have no potential conflicts of interest to disclose. Publisher Copyright: {\textcopyright} Copyright 2017, Mary Ann Liebert, Inc. 2017.",
year = "2017",
month = nov,
doi = "10.1089/apc.2017.0145",
language = "English (US)",
volume = "31",
pages = "447--454",
journal = "AIDS Patient Care and STDs",
issn = "1087-2914",
publisher = "Mary Ann Liebert Inc.",
number = "11",
}
