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They also observed 21% fewer events of cardiovascular events and death in patients, said Desvigne-Nickens. In the trial, the researchers found that HIV-positive patients taking pitavastatin were about 35% less likely to experience an “adverse” cardiovascular event, like a heart attack, than the control group. “This is where REPRIEVE fits in very nicely.” “They wouldn’t typically be recommended a primary prevention drug strategy because the risk is in the low to moderate range because there’s been no data,” said Grinspoon. That omission creates a blind spot for patients with HIV who score lower on the risk assessment and aren’t prescribed pitavastatin, but still have a disproportionately high rate of heart conditions. The American Heart Association and American College of Cardiology’s standard risk-assessment, which includes criteria such as age, sex and ethnicity, don’t include HIV-related cardiovascular risk factors, either.

Pitavastatin, however, isn’t typically given to patients with a “low-to-moderate” risk of heart disease, like people with HIV might be. The medication is also widely available at “relatively cheap” prices, Grinspoon noted.

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It was specifically chosen for the HIV trial because it doesn’t interact with antiretroviral drugs, making it “amazingly perfect,” according to Desvigne-Nickens.

As a result, the drug lowers the low-density lipoprotein (LDL) cholesterol – or “bad cholesterol,” as Desvigne-Nickens described it – that can build up inside blood vessels and cause heart problems. Pitavastatin belongs to a class of pharmaceuticals called statins that reduce the amount of cholesterol made by the liver and help the liver break down cholesterol in the blood. In this double-blind setup, neither the patients nor their treating physicans knew which one they were getting. Named the REPRIEVE trial, the study recruited more than 7,700 participants worldwide between the ages of 40 and 75, all of whom had HIV, were currently taking antiretroviral medication, and were rated to have a low-to-moderate risk of heart disease.Įach participant was randomly assigned to take a daily dose of pitavastatin or a placebo tablet. They’re not having HIV-specific comorbidities they’re having heart disease.” “They’re still having heart attacks and strokes, despite being on good, effective antiretroviral therapies. Steven Grinspoon, a professor of medicine at Harvard Medical School and the study’s lead author.

“This is becoming a major issue for the HIV community,” said Dr. While scientists aren’t sure exactly why, experts believe it could be a consequence of high, persistent inflammation and chronic immune activation from HIV. Heart complications happen much earlier – and are deadlier – for people with HIV. Patrice Desvigne-Nickens, a physician at the National Heart, Lung, and Blood Institute’s Division of Cardiovascular Sciences, who worked on the trial. People with HIV, however, face up to double the risk of heart disease and cardiovascular complications compared to the general population, said Dr. A pharmacist pours Truvada pills back into the bottle at Jack's Pharmacy on November 23, 2010, in San Anselmo, California.

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