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Statin Utilization and Recommendations Among HIV- and HCV-infected Veterans: A Cohort Study.

Publication ,  Journal Article
Clement, ME; Park, LP; Navar, AM; Okeke, NL; Pencina, MJ; Douglas, PS; Naggie, S
Published in: Clin Infect Dis
August 1, 2016

BACKGROUND: Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections are associated with increased risk of cardiovascular disease (CVD). The potential impact of recently updated cholesterol guidelines on treatment of HIV- and HCV-infected veterans is unknown. METHODS: We performed a retrospective cohort study to assess statin use and recommendations among 13 579 HIV-infected, 169 767 HCV-infected, and 6628 HIV/HCV-coinfected male veterans aged 40-75 years. Prior 2004 Adult Treatment Panel (ATP-III) guidelines were compared with current 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guidelines and 2014 US Department of Veterans Affairs (VA)/US Department of Defense (DoD) joint clinical practice guidelines using laboratory, medication, and comorbidity data from the VA Clinical Case Registry from 2008 through 2010. RESULTS: Using risk criteria delineated by the ATP-III guidelines, 50.6% of HIV-infected, 45.9% of HCV-infected, and 33.8% of HIV/HCV-coinfected veterans had an indication for statin therapy. However, among those eligible, 22.7%, 30.5%, and 31.5%, respectively, were not receiving ATP-III recommended statin therapy. When current cholesterol guidelines were applied by VA/DoD and ACC/AHA criteria, increases in recommendations for statins were found in all groups (57.3% and 66.1% of HIV-infected, 64.4% and 73.7% of HCV-infected, 49.1% and 58.5% of HIV/HCV-coinfected veterans recommended). CONCLUSIONS: Statins were underutilized among veterans infected with HIV, HCV, and HIV/HCV according to previous ATP-III guidelines. Current VA/DoD and ACC/AHA guidelines substantially expand statin recommendations and widen the gap of statin underutilization in all groups. These gaps in care present an opportunity to improve CVD prevention efforts in these at-risk populations.

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Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

August 1, 2016

Volume

63

Issue

3

Start / End Page

407 / 413

Location

United States

Related Subject Headings

  • Veterans
  • United States Department of Veterans Affairs
  • United States
  • Societies, Medical
  • Risk
  • Retrospective Studies
  • Practice Guidelines as Topic
  • Middle Aged
  • Microbiology
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Clement, M. E., Park, L. P., Navar, A. M., Okeke, N. L., Pencina, M. J., Douglas, P. S., & Naggie, S. (2016). Statin Utilization and Recommendations Among HIV- and HCV-infected Veterans: A Cohort Study. Clin Infect Dis, 63(3), 407–413. https://doi.org/10.1093/cid/ciw289
Clement, Meredith E., Lawrence P. Park, Ann Marie Navar, Nwora Lance Okeke, Michael J. Pencina, Pamela S. Douglas, and Susanna Naggie. “Statin Utilization and Recommendations Among HIV- and HCV-infected Veterans: A Cohort Study.Clin Infect Dis 63, no. 3 (August 1, 2016): 407–13. https://doi.org/10.1093/cid/ciw289.
Clement ME, Park LP, Navar AM, Okeke NL, Pencina MJ, Douglas PS, et al. Statin Utilization and Recommendations Among HIV- and HCV-infected Veterans: A Cohort Study. Clin Infect Dis. 2016 Aug 1;63(3):407–13.
Clement, Meredith E., et al. “Statin Utilization and Recommendations Among HIV- and HCV-infected Veterans: A Cohort Study.Clin Infect Dis, vol. 63, no. 3, Aug. 2016, pp. 407–13. Pubmed, doi:10.1093/cid/ciw289.
Clement ME, Park LP, Navar AM, Okeke NL, Pencina MJ, Douglas PS, Naggie S. Statin Utilization and Recommendations Among HIV- and HCV-infected Veterans: A Cohort Study. Clin Infect Dis. 2016 Aug 1;63(3):407–413.
Journal cover image

Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

August 1, 2016

Volume

63

Issue

3

Start / End Page

407 / 413

Location

United States

Related Subject Headings

  • Veterans
  • United States Department of Veterans Affairs
  • United States
  • Societies, Medical
  • Risk
  • Retrospective Studies
  • Practice Guidelines as Topic
  • Middle Aged
  • Microbiology
  • Male