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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

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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
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RM Therapeutics. Pharmacology
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
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
Dates:
DateEvent
5 June 2018Published
23 May 2018Accepted
Date of first compliant deposit: 31 May 2018
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:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIED[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
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