Abstract
BACKGROUND: People living with HIV (PLWH) are more vulnerable to cerebrovascular disease, including coronary artery disease. Dyslipidemia is a risk factor for major adverse cardiovascular events in this population as a whole. Dyslipidemia might result from general risk factors, HIV itself, or the adverse effects of the antiretroviral drug, which have different effects on lipid profile. The present study aims to review the latest studies regarding the role of statin initiation in this population and clinically significant drug interactions in the field. METHODS: Databases, including Scopus, PubMed, Google Scholar, EMBASE, and Web of Science, were searched for relevant literature on the role of statins in primary/secondary prevention of CVD in PLWH based on the PICO search strategy. Moreover, ARTs-statin drug interactions were investigated and summarized based on the University of Liverpool's website. RESULTS: Nearly 70 studies were found and summarized. Guidelines recommendations for using statins in PLWH and current practice, as well as the role and potential mechanism of statins in PLWH, were investigated. Based on the available data, we developed a practical algorithm that clinicians can use to optimize statin therapy in PLWH. CONCLUSION: More studies are required to fully define the role of statins in HIV patients, including time to initiate and proper dosing. Moreover, a marked inconsistency exists between clinical guidelines and actual practice, mainly due to irrational concerns regarding antiretroviral-statin drug interactions.