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

Olalekan A. Uthman; Chidozie Nduka; Samuel I. Watson; Edward J. Mills; Andre P. Kengne; Shabbar Jaffar; Aileen Clarke; Tahereh Moradi; Anna Mia Ekström; Richard Lilford

doi:10.1186/s12879-018-3162-1

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

Olalekan A. Uthman
, Chidozie Nduka
, Samuel I. Watson
, Edward J. Mills
, Andre P. Kengne
, Shabbar Jaffar
, Aileen Clarke
, Tahereh Moradi
, Anna Mia Ekström
, Richard Lilford

International Public Health

Research output: Contribution to journal › Article › peer-review

27 Citations (Scopus)

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.

Original language	English
Article number	258
Pages (from-to)	258
Journal	BMC Infectious Diseases
Volume	18
Issue number	1
DOIs	https://doi.org/10.1186/s12879-018-3162-1
Publication status	Published - 5 Jun 2018

Keywords

HIV
Mortality
Statin

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1186/s12879-018-3162-1Licence: CC BY

BMC Infectious diseases statin use and all-cause mortality in people living with HIVFinal published version, 561 KBLicence: CC BY

Cite this

@article{0f91a2d195234a46b66bb7b9731b2050,

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

abstract = "BACKGROUNDIt 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.METHODSWe 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.RESULTSWe 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.CONCLUSIONStatin use appears to confer moderate mortality benefits in people living with HIV.",

keywords = "HIV, Mortality, Statin",

author = "Uthman, \{Olalekan A.\} and Chidozie Nduka and Watson, \{Samuel I.\} and Mills, \{Edward J.\} and Kengne, \{Andre P.\} and Shabbar Jaffar and Aileen Clarke and Tahereh Moradi and Ekstr{\"o}m, \{Anna Mia\} and Richard Lilford",

year = "2018",

month = jun,

day = "5",

doi = "10.1186/s12879-018-3162-1",

language = "English",

volume = "18",

pages = "258",

journal = "BMC Infectious Diseases",

issn = "1471-2334",

publisher = "BioMed Central Ltd",

number = "1",

}

TY - JOUR

T1 - Statin use and all-cause mortality in people living with HIV: a systematic review and meta-analysis.

AU - Uthman, Olalekan A.

AU - Nduka, Chidozie

AU - Watson, Samuel I.

AU - Mills, Edward J.

AU - Kengne, Andre P.

AU - Jaffar, Shabbar

AU - Clarke, Aileen

AU - Moradi, Tahereh

AU - Ekström, Anna Mia

AU - Lilford, Richard

PY - 2018/6/5

Y1 - 2018/6/5

N2 - BACKGROUNDIt 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.METHODSWe 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.RESULTSWe 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.CONCLUSIONStatin use appears to confer moderate mortality benefits in people living with HIV.

AB - BACKGROUNDIt 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.METHODSWe 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.RESULTSWe 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.CONCLUSIONStatin use appears to confer moderate mortality benefits in people living with HIV.

KW - HIV

KW - Mortality

KW - Statin

U2 - 10.1186/s12879-018-3162-1

DO - 10.1186/s12879-018-3162-1

M3 - Article

SN - 1471-2334

VL - 18

SP - 258

JO - BMC Infectious Diseases

JF - BMC Infectious Diseases

IS - 1

M1 - 258

ER -

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

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this