Effectiveness of statins in people living with HIV: a systematic review and meta-analysis of randomized controlled trials

ABSTRACT

Introduction

People living with HIV (PLWH) receiving statin therapy have shown improved lipid profiles. However, they are not free from side effects, thereby requiring strict monitoring of the therapy. The meta-analysis aims to analyze the effect of statins in PLWH and critically appraise the effectiveness of statin therapy in PLWH.

Methods

PubMed, Scopus, and Web of Science servers were used to conduct a systematic search in compliance with the PRISMA guidelines. The meta-analysis of pooled effect estimates is produced using Revman software.

Results

A total of 12 RCTs with 8716 participants were included in the analysis. Analysis of the overall effect estimates found that statins resulted in a mean reduction of 41.15 mg/dl (MD = −41.15; 95% CI: −44.19, −38.11; p < 0.00001), 34.99 mg/dl (MD = −34.99; 95% CI: −34.99; 95% CI: −41.16, −28.82; p < 0.00001), and 7.36 mg/dl (MD = −7.36; 95% CI = −48.35, −33.62; p < 0.00001) in total cholesterol, low-density lipoprotein, and triglyceride levels, respectively. It is revealed that statins are associated with a significant increase in the discontinuation rate of treatment compared to placebo treatment (RR: 1.90; 95% CI: 1.36–2.65; p = 0.0002).

Conclusion

When considered collectively, statin therapy’s advantages appear to exceed its occasional predictable side effects like liver or muscle toxicity.

Registration

PROSPERO registration ID: CRD42023469521.

KEYWORDS:

• Atherosclerosis
• HIV
• lipid profile
• people living with HIV
• statins

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

A literature search for relevant publications was done by two authors (DA and SSM). Screening of the articles and data extraction were done by eight authors (DJS, VR, TT, MSK, RJS, MF, SKA, and MS). The final data table was curated by RGB. Data analysis was done by DA and SSM. The manuscript was written by all the authors. Final editing and proofreading of the article were done by DA, SSM, and RGB.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17512433.2024.2344672.

Additional information

Funding

This paper was not funded.