HIV and Cardiovascular Disease: Statin Medications for Prevention

2023-10-29 02:04:26

Money Today Reporter Lee Chang-seop | 2023.10.29 11:04

People infected with HIV, the virus that causes AIDS, can now live until the age of 80
As life expectancy increases, the threat of cardiovascular disease… Effects of statin drugs
Attention is paid to two-drug therapy with fewer drug ingredients… “Side effects will be reduced”

A study was published showing that people infected with HIV (Human Immunodeficiency Virus) can prevent cardiovascular disease by consistently taking hyperlipidemia medication like the general public. People infected with HIV have up to two times the risk of developing cardiovascular diseases, such as heart attack, than non-infected people. As life expectancy approaches 80, people will need to take medication for chronic diseases in addition to HIV treatment for the rest of their lives. Since there are up to 65,700 drug ingredients that must be taken in a lifetime, HIV treatments that reduce the number of drugs have recently been attracting attention. According to industry sources on the 29th, the world-renowned medical journal ‘New England Journal of Medicine’ (NEJM) recently disclosed the results of a clinical trial in which hyperlipidemia medication was administered consistently to HIV-infected patients at risk of cardiovascular disease.

When pitavastatin, a statin drug, was administered to 7,769 HIV-infected people for 5 years, the incidence of cardiovascular diseases such as heart attack and stroke decreased by 35% compared to the placebo group. The risk of death from cardiovascular disease also decreased by 21%.

HIV is often misunderstood as having the same meaning as AIDS (acquired immunodeficiency syndrome), but it is completely different. HIV is the cause of AIDS. However, not all carriers develop AIDS. If you take the treatment consistently, it will not develop into AIDS. Additionally, the life expectancy of HIV patients is 78 years. It is not much different from the average life expectancy of 80 years for non-infected people in Korea.

However, it is known that the risk of cardiovascular diseases such as heart attack, myocardial infarction, and atherosclerosis among HIV-infected people is up to two times higher than that of non-infected people. In fact, the cardiovascular disease prevention guidelines consider ‘HIV infection’ as a risk factor. The general public prepares for cardiovascular disease by taking hyperlipidemia medication, but there are no prevention recommendations for HIV-infected people. This is because there was no related research.

This is why the clinical trial results published this time in NEJM are meaningful. It was revealed that HIV-infected people can prevent cardiovascular disease by taking statins consistently like non-infected people. This also means that the number of medications that HIV-infected people must take throughout their lives, in addition to HIV treatment, has increased.

Song Joon-young, a professor of infectious diseases at Korea University Guro Hospital, explained, “This is a clinical study that confirmed the importance of statin treatment for cardiovascular prevention in HIV-infected people.”

He explained, “More importantly, it suggests that drug-drug interactions should be taken into consideration when treating various comorbidities with drugs for HIV-infected people who are at risk for not only cardiovascular disease but also diabetes, bone disease, and kidney and liver disease.”

HIV-infected people usually take antiviral medication, taking one pill a day. The existing medicine combines three ingredients into one pill. Assuming that you are diagnosed with HIV at age 20 and take it until you are 80, you will take 65,700 medications (ingredients) in your lifetime. Excessive use of drugs is not good. This is because drugs can interact and cause unintended side effects such as toxicity.

Professor Song said, “In HIV treatment, selecting drugs with a low risk of developing comorbidities and reducing the number of drugs can be an effective treatment option.”
This is why the relatively recently introduced two-drug single-drug HIV treatment is attracting attention. Because one ingredient is reduced, the number of drugs that HIV patients take over their lifetime is reduced by more than 20,000. The burden of the treatment process, such as side effects and toxicity due to drug-drug interactions, can be reduced. Even though the number of ingredients was reduced, it showed the same HIV suppression effect compared to multi-drug therapy, which has been the standard treatment since 1990. In a clinical trial conducted on 493 HIV-infected people, the two-drug treatment treatment was the same as the three- and four-drug treatment.

Two-drug therapy is relatively safe even against major adverse effects of existing HIV treatments, such as changes in cholesterol levels. When two-drug therapy was administered for a long period of time, the level of HDL (high-density cholesterol), called good cholesterol, increased. On the other hand, LDL (low-density cholesterol) levels and triglycerides tended to decrease.

Professor Song said, “HIV and AIDS are now recognized as chronic diseases, and given that the life expectancy of infected people is not much different from that of non-infected people, treatment that takes into account their various comorbidities is necessary,” adding, “Two-drug treatment is recommended for HIV-infected people.” “It is expected to provide a variety of benefits, including lowering the risk of side effects that may occur from taking multiple medications,” he said.

He continued, “From a long-term perspective, not only initial treatment for HIV-infected patients, but also switching for patients who have experience with existing antiviral treatment can be considered as a good option.”

[저작권자 @머니투데이, 무단전재 및 재배포 금지]

#Hyperlipidemia #medication #reduces #risk #cardiovascular #disease #HIV #patients #mind

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