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Statin use and all-cause mortality in people living with HIV: a systematic review and meta-analysis.

Uthman, Olalekan A, Nduka, Chidozie, Watson, Samuel I, Mills, Edward J, Kengne, Andre P, 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, Vol 18, Issue 1, p. 258.

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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: Article
Subjects: WA Public Health > WA 100 General works
WB Practice of Medicine > Therapeutics > WB 330 Drug therapy
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1186/s12879-018-3162-1
Depositing User: Stacy Murtagh
Date Deposited: 12 Jun 2018 14:56
Last Modified: 30 Jul 2018 14:53
URI: http://archive.lstmed.ac.uk/id/eprint/8764

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