title: Low-Density Lipoprotein Cholesterol Levels and Statin Treatment by HIV Status Among Multicenter AIDS Cohort Study Men.
abstract: Treating cardiovascular disease (CVD) risk factors, including dyslipidemia, is important in HIV care. Low-density lipoprotein cholesterol (LDL-c) target achievement is a readily available benchmark for dyslipidemia control, although use of this target is not uniformly endorsed by professional societies. We examined whether HIV serostatus is associated with not achieving LDL-c target. Among Multicenter AIDS Cohort Study (MACS) participants completing visit 56 (10/1/2011-3/31/2012), we categorized each man as on or off statin therapy and used NCEP ATP III guidelines to determine if each man was at LDL-c target or not at target. We compared proportions of men not at target and determined predictors using multivariate logistic regression. Sixty of 543 (11.1%) HIV-infected men and 87 of 585 (14.9%) HIV-uninfected men not receiving statin therapy were not at target (p=0.07), while 31 of 230 (13.5%) HIV-infected and 29 of 204 (14.2%) HIV-uninfected men receiving statin therapy were not at target (p=0.82). Factors associated with not being at target (among men not receiving statin therapy) included current smoking (OR=2.31, 95% CI 1.31, 4.06) and a diagnosis of hypertension (OR=4.69, 95% CI 2.68, 8.21). Factors associated with not being at target (among men receiving statin therapy) included current smoking (OR=2.72, 95% CI 1.30, 5.67) and diabetes (OR=5.31, 95% CI 2.47, 11.42). HIV-infected and HIV-uninfected men receiving statin therapy demonstrated similar nonachievement of LDL-c targets. Comorbidities (e.g., diabetes) lowered targets and may explain why goals were less likely to be met.
authors: 1Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: Anne K
authors: AK
authors: Monroe
authors: 2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors: Wei
authors: W
authors: Fu
authors: 3Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: Michelle N
authors: MN
authors: Zikusoka
authors: 2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors: Lisa P
authors: LP
authors: Jacobson
authors: 4Division of HIV Medicine, Harbor UCLA Medical Center, Torrence, California.
authors: Mallory D
authors: MD
authors: Witt
authors: 5Division of Infectious Diseases, Feinberg School of Medicine of Northwestern University, Chicago, Illinois.
authors: Frank J
authors: FJ
authors: Palella
authors: 6Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
authors: Lawrence A
authors: LA
authors: Kingsley
authors: 2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.|3Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: Wendy S
authors: WS
authors: Post
authors: Todd T
authors: TT
authors: Brown
mesh_terms: D002318:Cardiovascular Diseases / Q000517:prevention & control; D008078:Cholesterol, LDL / Q000097:blood*; D015331:Cohort Studies; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D006903:Hydroxymethylglutaryl CoA Reductases / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged
chemical_list: D008078:Cholesterol, LDL; D006903:Hydroxymethylglutaryl CoA Reductases