Health-related quality of life among people with HIV at low-to-moderate risk for atherosclerotic cardiovascular disease in the REPRIEVE Trial.

BACKGROUND: There is limited evidence concerning the relationship between cardiometabolic characteristics and health-related quality of life (HRQoL), and potential effects of statin therapy among people with HIV (PWH). METHODS: The Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) enrolled PWH aged 40-75 years on antiretroviral therapy (ART) with low-to-moderate ASCVD risk. Coronary computed tomography angiography assessed coronary plaque among a subset of participants in the REPRIEVE Mechanistic Substudy at baseline and 24 months. The Short Form-36-Item Health Survey Version 2 was collected at baseline, and physical (PCS) and mental (MCS) component summary scores were determined. We explored the relationship of PCS and MCS with cardiometabolic characteristics, coronary atherosclerosis, and assessed change in score by treatment group (pitavastatin vs. placebo). RESULTS: Of 733 participants, median age was 51 years, 84% were male, 34% were Black non-Hispanic, and median years diagnosed with HIV was 15. At baseline, for participants randomized to pitavastatin vs. placebo the median PCS was 54.5 (Q1, Q3: 46.9, 57.7) vs. 54.1 (47.5, 58.0), and the median MCS was 52.9 (44.1, 57.6) vs. 52.8 (44.0, 57.9). In fully adjusted analyses, older age, Black non-Hispanic race/ethnicity, ART regimen class, elevated BMI, and cigarette smoking were associated with lower PCS. No clear trends were apparent with MCS. Between baseline and month 24, declines in PCS and MCS were minimal with no apparent difference by treatment group. CONCLUSIONS: Among this cohort of ART-treated PWH, baseline cardiometabolic risk factors were associated with worse self-reported physical HRQoL, with no apparent effect of statin therapy. TRIAL REGISTRATION: REPRIEVE; NCT02344290; https://clinicaltrials.gov/study/NCT02344290.

Duke Scholars

Author Pamela Susan Douglas Medicine, Cardiology

Author Gerald Bloomfield Medicine, Cardiology