Giorgia Carrozzo, Beatrice Caloni, Letizia Oreni, Giacomo Pozza, Maria Vittoria Cossu, Davide Moschese, Valentina Iannone, Maddalena Matone, Valeria Colombo, Andrea Poloni, Stefania Caronni, Anna Lisa Ridolfo, Cristina Gervasoni, Aldo Pietro Maggioni, Spinello Antinori, Agostino Riva, Andrea Gori, Andrea Giacomelli
Statin prescription increased after the 2024 guideline update, but LDL-C target attainment remained poor, suggesting incomplete implementation of guideline-recommended lipid management in routine HIV care.
BACKGROUND AND AIMS: The 2024 EACS guidelines introduced stricter LDL-C targets, emphasizing lipid management in people with HIV (PWH). We aimed to assess changes in statin prescription following the guideline update.
METHODS AND RESULTS: This retrospective, single-center study compared PWH aged ≥40 years attending follow-up visits between April 2023-April 2024 (Period 1) and April 2024-April 2025 (Period 2). Lipid-lowering therapy use and LDL-C target attainment were evaluated according to 2024 EACS criteria. A total of 1379 individuals were included in Period 1 and 1191 in Period 2. Median LDL-C decreased from 116 mg/dL (IQR 92-139) to 111 mg/dL (IQR 84-137). Statin use increased from 38% to 49% (aOR 1.47, 95% CI 1.37-1.58; p < 0.0001), with greater use of statin-ezetimibe combination therapy (9% vs 19%, p < 0.0001). LDL-C target attainment remained low (8% vs 10%). In multivariable analysis, individuals of African (aOR 0.39, 95% CI 0.21-0.72; p = 0.003) and Hispanic (aOR 0.35, 95% CI 0.19-0.62; p < 0.001) origin had lower odds of receiving statins compared with Caucasians.
CONCLUSIONS: Statin prescription increased after the 2024 guideline update, but LDL-C target attainment remained poor, suggesting incomplete implementation of guideline-recommended lipid management in routine HIV care.