HIV confab hears news about heart disease, mpox

by Liz Highleyman

The International AIDS Society Conference on HIV Science, held recently in Brisbane, Australia, included new findings on a medication to prevent heart disease and the risk of severe mpox among people living with HIV.

REPRIEVE trial results

HIV-positive people who are at low to moderate risk for cardiovascular disease can reduce their risk even further by taking a daily statin medication, according to results from the large REPRIEVE study. Statins have been shown to lower the risk of cardiovascular problems and death in the general population, but their benefits for people living with HIV were uncertain until now.

“People with HIV are twice as likely to develop cardiovascular disease, and therefore [the findings] could have very significant real-world impact,” IAS president and conference co-chair Dr. Sharon Lewin of the University of Melbourne said at an advance media briefing.

The international phase 3 trial, sponsored by the National Institutes of Health, enrolled nearly 7,800 HIVpositive people ages 40 to 75. They were on antiretroviral therapy and most had an undetectable viral load. They had no prior history of cardiovascular disease, and their demographics, comorbidities and laboratory values reflected low to moderate risk. But standard cardiovascular risk scores developed for the general population tend to underestimate

From whose full name was the California Task Force to Study and Develop Reparation Proposals for African Americans.

Rather than coming up with a lump sum payment, the task force suggested a new entity be established by the Legislature that could receive claims for compensation due to various discriminatory policies faced by eligible individuals, process them, and render payments “in an efficient and timely manner.” the risk for people with HIV.

“We targeted a group that would not ordinarily have been prescribed a statin, or any therapy, who would have been simply told to go home,” lead researcher Dr. Steven Grinspoon of Massachusetts General Hospital said at the briefing. Study participants were randomly assigned to receive oral pitavastatin (brand name Livalo) or a placebo. In addition to bringing down LDL cholesterol, statins also have anti-inflammatory properties. Pitavastatin was chosen because it does not interact with antiretrovirals.

The trial was halted ahead of schedule in April after an interim analysis found that pitavastatin showed a significant benefit. The drug reduced the risk of

It also offered suggestions for what payments eligible people could receive, such as $13,619 being its “estimated value of health harm to each year of life an African American individual has spent in California, to which an eligible descendant would be entitled.” The task force report also included a way to compensate Black non-Hispanics for the excess drug felony arrests they have faced that it estimated would cost the state $228 billion (in 2020 dollars) to pay out in reparations.

At the time of the task force report’s heart attacks, strokes, severe chest pains, heart surgery and cardiovascular death by 35%.

The researchers calculated that, overall, 106 HIV-positive people would need to take pitavastatin for five years to prevent one major cardiovascular event. But for those with a higher cardiovascular risk score, that number fell to 35. The size of the effect was “very consistent” for men and women, across racial/ethnic groups and regardless of CD4 T-cell count or baseline LDL level, Grinspoon reported.

Pitavastatin was generally safe and well tolerated with no unanticipated safety concerns. People who received the drug were more likely than placebo recipients to develop diabetes, but the rates were low (about 5% versus 4%). Muscle-related side effects were also uncommon (about 2% versus 1%) and mostly mild.

“We would highly recommend that guidelines be changed” to recommend statin therapy for HIVpositive people with low to moderate cardiovascular risk, Grinspoon said. “Pitavastatin is effective, prevents major adverse cardiovascular events and will save lives.” release, Governor Gavin Newsom avoided directly answering reporters’ questions about the idea of cash payments. In the spring he had made headlines for saying about reparations to the descendants of enslaved people that “dealing with that legacy is about much more than cash payments.”

Grinspoon noted that statins are cheap once they go off patent – as is expected for pitavastatin in early 2024 – which will help ensure equitable access. He stressed that statin use should be part of a broader cardiovascular disease prevention plan that emphasizes a heart healthy lifestyle.

While hailing the task force for issuing its final report, lesbian Senate President pro Tempore Toni Atkins (D-San Diego) made no mention of any cash amount for reparations in her statement she had issued June 29. She did say the document