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Statin use and all-cause mortality in people living with HIV : a systematic review and meta-analysis
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Uthman, Olalekan A., Nduka, Chidozie U., Watson, Samuel I., Mills, Edward, Kengne, Andre, Jaffar, Shabbar, Clarke, Aileen, Moradi, Tahereh, Ekström, Anna Mia and Lilford, Richard (2018) Statin use and all-cause mortality in people living with HIV : a systematic review and meta-analysis. BMC Infectious Diseases, 18 . 258. doi:10.1186/s12879-018-3162-1
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Official URL: https://doi.org/10.1186/s12879-018-3162-1
Abstract
Background
It is unknown whether statin use among people living with HIV results in a reduction in all-cause mortality. We aimed to evaluate the effect of statin use on all-cause mortality among people living with HIV.
Methods
We conducted comprehensive literature searches of Medline, Embase, CINAHL, the Cochrane Library, and cross-references up to April 2018. We included randomised, quasi-randomised trials and prospective cohort studies that examined the association between statin use and cardio-protective and mortality outcomes among people living with HIV. Two reviewers independently abstracted the data. Hazard ratios (HRs) were pooled using empirical Bayesian random-effect meta-analysis. A number of sensitivity analyses were conducted.
Results
We included seven studies with a total of 35,708 participants. The percentage of participants on statins across the studies ranged from 8% to 35%. Where reported, the percentage of participants with hypertension ranged from 14% to 35% and 7% to 10% had been diagnosed with diabetes mellitus. Statin use was associated with a 33% reduction in all-cause mortality (pooled HR = 0.67, 95% Credible Interval 0.39 to 0.96). The probability that statin use conferred a moderate mortality benefit (i.e. decreased risk of mortality of at least 25%, HR≤0.75) was 71.5%. Down-weighting and excluding the lower quality studies resulted in a more conservative estimate of the pooled HR
Conclusion
Statin use appears to confer moderate mortality benefits in people living with HIV.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RM Therapeutics. Pharmacology |
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| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Statins (Cardiovascular agents), HIV-positive persons | ||||||
| Journal or Publication Title: | BMC Infectious Diseases | ||||||
| Publisher: | BioMed Central Ltd. | ||||||
| ISSN: | 1471-2334 | ||||||
| Official Date: | 5 June 2018 | ||||||
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| Volume: | 18 | ||||||
| Article Number: | 258 | ||||||
| DOI: | 10.1186/s12879-018-3162-1 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access | ||||||
| RIOXX Funder/Project Grant: |
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