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Analysis from a large international clinical trial funded by the National Institutes of Health indicates that standard risk calculators underestimate the risk of cardiovascular events among individuals with HIV, particularly in Black individuals and cisgender women. These findings were presented at the 2024 Conference on Retroviruses and Opportunistic Infections (CROI) in Denver.

risk of cardiovascular events among individuals with HIV, particularly in Black individuals and cisgender women.

Key Findings

Elevated Risk

The study revealed that the risk of experiencing a first major cardiovascular event was higher than previously predicted, especially for those from high-income regions and individuals with detectable HIV replication. Notably, Black participants and cisgender women experienced higher event rates than predicted.

Risk Factors

Analysis of risk factors contributing to major adverse cardiovascular events identified several key factors including age over 50, Black ethnicity, smoking history, hypertension, family history of early cardiovascular disease, and detectable HIV viral load.

REPRIEVE Trial

The REPRIEVE trial, which enrolled over 7,700 individuals across five continents, demonstrated that pitavastatin calcium lowered the risk of major adverse cardiovascular events by 35% compared to a placebo. This led to recommendations for statin therapy in people with HIV.

Implications

These findings underscore the need for updated tools to accurately assess cardiovascular risk in people with HIV and emphasize the importance of representative inclusion in clinical trials.

Next Steps

An overview of the REPRIEVE trial, along with new findings and guideline updates, will be presented at the CROI symposium titled “Follow Your Heart: Managing Cardiovascular Disease Risk in HIV.”

NIH HIV

Table of Contents

? Key Findings
? Elevated Risk
? Risk Factors
? REPRIEVE Trial
? Implications
? Next Steps

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Tools underestimate cardiovascular event risk in people with HIV