Case 5. The Heart of the Matter: Cardiovascular Disease Risk in HIV

New COVID-19 vaccine policy, proviral DNA testing, then the case of a woman with 10+ years viral suppression, CKD, and CVD, identified as a statin candidate after a significant cardiac event. With no family history of CVD, her risks included exposure to older ARVs and smoking 1 to 3 cigarettes/day. Listen as Drs. Scully and Hoffmann delve into non-infectious comorbidities associated with HIV, risk factors, and adjusted CVD risk calculation for women and African Americans.References CitedBeavers C, Pau AK, Glidden D, et al. Statin Therapy as Primary Prevention for Persons With HIV: A Synopsis of Recommendations From the U.S. Department of Health and Human Services Antiretroviral Treatment Guidelines Panel. Ann Intern Med. Published online May 27, 2025. PMID: 40418812D:A:D Study Group, Sabin CA, Worm SW, et al. Use of nucleoside reverse transcriptase inhibitors and risk of myocardial infarction in HIV-infected patients enrolled in the D:A:D study: a multi-cohort collaboration [published correction appears in Lancet. 2008 Jul 26;372(9635):292]. Lancet. 2008;371(9622):1417-1426. PMID: 18387667Elion RA, Althoff KN, Zhang J, et al. Recent Abacavir Use Increases Risk of Type 1 and Type 2 Myocardial Infarctions Among Adults With HIV. J Acquir Immune Defic Syndr. 2018;78(1):62-72. PMID: 29419568Fichtenbaum CJ, et al “Abacavir is associated with elevated risk for cardiovascular events in the REPRIEVE trial” IAC 2024; Abstract OAB3406LB.Grinspoon SK, Zanni MV, Triant VA, et al. Performance of the pooled cohort equations and D:A:D risk scores among individuals with HIV in a global cardiovascular disease prevention trial: a cohort study leveraging data from REPRIEVE. Lancet HIV. 2025;12(2):e118-e129. PMID: 39832519SMART Study Group, El-Sadr WM, Lundgren J, et al. CD4+ count-guided interruption of antiretroviral treatment. N Engl J Med. 2006;355(22):2283-2296. PMID: 171355583 Prasad V, Makary MA. An Evidence-Based Approach to Covid-19 Vaccination. N Engl J Med. Published online May 20, 2025. PMID: 40392534Ridker PM, Danielson E, Fonseca FA, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359(21):2195-2207. PMID: 18997196Selinger S. In adults with HIV and low-to-moderate CV risk, pitavastatin reduced MACE over a median 5.1 y. Ann Intern Med. 2023;176(11):JC130. PMID: 37931263Wensing AM, Charpentier C, Calvez V, et al. Utilizing HIV Proviral DNA to Assess for the Presence of HIV Drug Resistance. Clin Infect Dis. Published online April 3, 2025. doi:10.1093/cid/ciaf161. PMID: 40176204.Related Guidelines from the NYSDOH AI Clinical Guidelines ProgramPrimary Care for Adults With HIV Immunizations for Adults With HIV: COVID-19