Abstract
Background
Although the HIV population is at an increased risk for cardiovascular disease, gaps in therapy have been described for HIV patients indicated for statin agents. This study aimed to compare statin prescribing rates between HIV-infected and uninfected patients. This is the first study comparing statin rates among these populations using the 2013 American College of Cardiology/American Heart Association lipid guidelines, which have broader inclusion criteria than previous guidelines.
Methods
This is a comparative, retrospective study reviewing patients eligible for a statin that had an encounter between February 1, 2017 and September 30, 2017 at two outpatient clinics within an urban, academic medical system. Patients that qualified for one of the following statin benefit groups were included: clinical atherosclerotic cardiovascular disease (ASCVD), low density lipoprotein cholesterol (LDL-C) ≥ 190 mg/dL, or diabetes with LDL-C 70–189 mg/dL between 40 and 75 years old. Patients less than 21 years old or without a lipid panel within the last 3 years were excluded. The primary outcome was the percentage of patients with HIV prescribed a statin compared with uninfected patients. Subanalyses assessed the statin gap in individual benefit groups and statin intensity distribution. Predictors associated with receiving a statin were analyzed using a logistic regression model.
Results
A total of 501 HIV-positive and 1625 HIV-negative patients met the study criteria. There was no statistical difference in statin prescribing rates for patients with HIV (60.7%) and those without (65.7%, OR 1.24 [0.86–1.78]). Patients with active smoking status (OR 1.28 [1.01–1.62]) or smoking history (OR 1.47 [1.17–1.84]), and older age (OR 1.05 [1.03–1.06]) were more likely to be prescribed a statin. No association was observed between prescribed statin and HIV status in each of the benefit groups. HIV patients more often received a medium intensity statin (OR 1.10 [0.52–2.32]), whereas uninfected patients more often received a high intensity statin (OR 0.43 [0.20–0.90]).
Conclusion
No difference in statin prescribing rates was observed in HIV vs. uninfected patients. This demonstrates the statin gap is pertinent regardless of HIV status and additional analysis is needed to investigate reasons for the gap in both populations.
Disclosures
All authors: No reported disclosures.
Session: 241. HIV: Metabolic, Cardiovascular, and Renal Complications
Saturday, October 6, 2018: 12:30 PM