Feinstein MJ, Bahiru E, Achenbach C, et al. Patterns of cardiovascular mortality for HIV-infected adults in the United States: 1999 to 2013. Am J Cardiol. 2016;117:214-220. Abstract
Triant VA, Lee H, Hadigan C, et al. Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease. J Clin Endocrinol Metab. 2007;92:2506-2512. Abstract
Subramanian S, Tawakol A, Burdo TH, et al. Arterial inflammation in patients with HIV. JAMA. 2012;308:379-386. Abstract
Zanni MV, Toribio M, Robbins GK, et al. Effects of antiretroviral therapy on immune function and arterial inflammation in treatment-naive patients with human immunodeficiency virus infection. JAMA Cardiol. 2016;1:474-480. Abstract
The DAD Study Group. Class of antiretroviral drugs and the risk of myocardial infarction. N Engl J Med. 2007;356:1723-1735. Abstract
Jacobson TA, Maki KC, Orringer CE, et al. National Lipid Association recommendations for patient-centered management of dyslipidemia: part 2. J Clin Lipidol. 2015;9:S1-122 e121.
Oh J, Hegele RA. HIV-associated dyslipidaemia: pathogenesis and treatment. Lancet Infect Dis. 2007;7:787-796. Abstract
Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63:2889-2934. Abstract
Antonopoulos AS, Margaritis M, Lee R, et al. Statins as anti-inflammatory agents in atherogenesis: molecular mechanisms and lessons from the recent clinical trials. Curr Pharmaceut Design. 2012;18:1519-1530.
Riddler SA, Smit E, Cole SR, et al. Impact of HIV infection and HAART on serum lipids in men. JAMA. 2003;289:2978-2982. Abstract
Vachiat A, McCutcheon K, Tsabedze N, et al. HIV and ischemic heart disease. J Am Coll Cardiol 2017;69:73-82.
Lo J, Lu MT, Ihenachor EJ, et al. Effects of statin therapy on coronary artery plaque volume and high-risk plaque morphology in HIV-infected patients with subclinical atherosclerosis. Lancet HIV. 2015;2:e52-e63. Abstract
Longenecker C, Sattar A, Gilkeson R, et al. Rosuvastatin slows progression of subclinical atherosclerosis in patients with treated HIV infection. AIDS. 2016;30:2195-2203. Abstract
US Food and Drug Administration. Drug safety communication: interactions between certain HIV or hepatitis C drugs and cholesterol-lowering statin drugs can increase the risk of muscle injury. https://www.fda.gov/Drugs/DrugSafety/ucm293877.htm. Accessed March 13, 2017.
ClinicalTrials.gov. Evaluating the use of pitavastatin to reduce the risk of cardiovascular disease in HIV-infected adults (REPRIEVE). https://clinicaltrials.gov/ct2/show/NCT02344290. Accessed March 8, 2017.
Sponseller CA, Kryzhanovski VA, Morgan RE, et al. After 52 weeks, pitavastatin is superior to pravastatin for LDL-C lowering in patients with HIV. Abstract 751LB. Presented at: CROI 2014 Conference on Retroviruses and Opportunistic Infections; March 3-6, 2014; Boston, MA.
Toribio M, Fitch KV, Sanchez L, et al. Effects of pitavastatin and pravastatin on markers of immune activation and arterial inflammation in HIV. AIDS. 2017;31:797-806. Abstract

CME / ABIM MOC / CE

5 Things You Need to Know About Statin Selection in Patients With HIV Infection

Authors: Steven Grinspoon, MD; James A. Underberg, MD
CME / ABIM MOC / CE Released: 3/27/2017
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 3/27/2018, 11:59 PM EST

Target Audience and Goal Statement

This activity is intended for cardiologists, infectious disease clinicians, endocrinologists, diabetes specialists, PCPs, nurses, pharmacists and all clinicians interested in statin therapy in special populations.

The goal of this activity is to outline the role of statin therapy as a strategy to reduce cardiovascular risk in persons with HIV infection.

Upon completion of this activity, participants will have:

Increased knowledge regarding the:

Burden of cardiovascular disease (CVD) in patients with HIV infection
The role of statin therapy to prevent CVD in patients with HIV infection

Increased competence related to:

The ability to tailor statin therapy in patients with HIV infection

Disclosures

As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.

Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.

Faculty

James A. Underberg, MD

Clinical Assistant Professor of Medicine, NYU School of Medicine; Director, Bellevue Hospital Lipid Clinic, NYU Center for Prevention of Cardiovascular Disease, New York, New York

Disclosures

Disclosure: James A. Underberg, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Akcea Therapeutics; Alexion Pharmaceuticals, Inc.; Amgen Inc.; Lilly; Merck & Co., Inc.; Recombine
Served as a speaker or a member of a speakers bureau for: Alexion Pharmaceuticals, Inc.; Amgen Inc.; Merck & Co., Inc.; Regeneron Pharmaceuticals, Inc.; Sanofi
Received grants for clinical research from: Aegerion Pharmaceuticals; Pfizer Inc.

Dr Underberg does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Underberg does intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Steven Grinspoon, MD

Professor of Medicine, Harvard Medical School; Director, Program in Nutritional Metabolism and Nutrition Obesity Research Center, Massachusetts General Hospital, Boston, Massachusetts

Disclosures

Disclosure: Steven Grinspoon, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Navidea Biopharmaceuticals; Theratechnologies Inc.
Received grants for clinical research from: Gilead Sciences, Inc.; Kowa Company Ltd.; Navidea Biopharmaceuticals; Theratechnologies Inc.

Dr Grinspoon does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Grinspoon does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Chair

Peter P. Toth, MD, PhD

Professor of Clinical Family and Community Medicine, University of Illinois; Director of Preventive Cardiology, CGH Medical Center, Sterling, Illinois

Disclosures

Disclosure: Peter P. Toth, MD, PhD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Amarin Corporation plc; Amgen Inc.; AstraZeneca; Kowa Company Ltd.; Merck & Co., Inc.; Regeneron Pharmaceuticals, Inc.; Sanofi
Served as a speaker or a member of a speakers bureau for: Amarin Corporation plc; Amgen Inc.; Kowa Company Ltd.; Merck & Co., Inc.; Regeneron Pharmaceuticals, Inc.; Sanofi

Members

Judith A. Aberg, MD

Professor of Medicine; Chief, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, New York

Disclosures

Disclosure: Judith A. Aberg, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Merck & Co., Inc.
Received grants for clinical research from: Bristol-Myers Squibb Company; GlaxoSmithKline; Gilead Sciences, Inc.

Eliot A. Brinton, MD

Director of Atherometabolic Research, Utah Foundation for Biomedical Research, Salt Lake City, Utah

Disclosures

Disclosure: Eliot A. Brinton, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Akcea Therapeutics; Alexion Pharmaceuticals, Inc.; Amarin Corporation plc; Amgen Inc.; Aralez Pharmaceuticals; Arisaph Pharmaceuticals; AstraZeneca; Kastle Therapeutics; Kowa Company Ltd.; Merck & Co., Inc.; PTS Diagnostics; Regeneron Pharmaceuticals, Inc.; Sanofi
Served as a speaker or a member of a speakers bureau for: Akcea Therapeutics; Alexion Pharmaceuticals, Inc.; Amarin Corporation plc; Amgen Inc.; Boehringer Ingelheim Pharmaceuticals, Inc.; Janssen Pharmaceuticals; Kastle Therapeutics; Kowa Company Ltd.; Lilly; Merck & Co., Inc.; Novo Nordisk; Regeneron Pharmaceuticals, Inc.; Sanofi
Received grants for clinical research from: Amarin Corporation plc; Kowa Company Ltd.

Alan S. Brown, MD

Advocate Heart Institute, Advocate Lutheran General Hospital, Park Ridge, Illinois

Disclosures

Disclosure: Alan S. Brown, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Akcea Therapeutics; Kastle Therapeutics; Merck & Co., Inc.; Regeneron Pharmaceuticals, Inc.; Sanofi
Served as a speaker or a member of a speakers bureau for: Amgen Inc.; Kowa Company Ltd.; Regeneron Pharmaceuticals, Inc.; Sanofi

Sergio Fazio, MD, PhD

Professor of Medicine; Director of Preventive Cardiology, Oregon Health & Science University, Portland, Oregon

Disclosures

Disclosure: Sergio Fazio, MD, PhD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Aegerion Pharmaceuticals, Inc.; Amarin Corporation plc; Amgen Inc.; Invitae Corporation; Kowa Company Ltd.; Merck & Co., Inc.; Sanofi

Kevin C. Maki, PhD

Chief Science Officer, MB Clinical Research, Glen Ellyn, Illinois

Disclosures

Disclosure: Kevin C. Maki, PhD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: AstraZeneca; DSM; Matinas BioPharma; Sancilio and Company, Inc.

Editor

Suzanne Hughes, RN, MSN

Scientific Director, Medscape, LLC

Disclosures

Disclosure: Suzanne Hughes, RN, MSN, has disclosed no relevant financial relationships.

CME Reviewer / Nurse Planner

Amy Bernard, MS, BSN, RN-BC

Lead Nurse Planner, Medscape, LLC

Disclosures

Disclosure: Amy Bernard, MS, BSN, RN-BC, has disclosed no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has disclosed the following relevant financial relationships: Served as an advisor consultant for: HeartWare; Medtronic; St Jude Medical; Thoratec.

Accreditation Statements

Medscape, LLC is accredited by the American Nurses Credentialing Center (ANCC), the Accreditation Council for Pharmacy Education (ACPE), and the Accreditation Council for Continuing Medical Education (ACCME), to provide continuing education for the healthcare team.

For Physicians

Medscape, LLC designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Medscape, LLC staff have disclosed that they have no relevant financial relationships.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.50 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Aggregate participant data will be shared with commercial supporters of this activity.

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This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

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You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates from the CME/CE Tracker.

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From Medscape Education Cardiology

CME / ABIM MOC / CE

5 Things You Need to Know About Statin Selection in Patients With HIV Infection

Authors: Steven Grinspoon, MD; James A. Underberg, MDFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CME / ABIM MOC / CE Released: 3/27/2017

Valid for credit through: 3/27/2018, 11:59 PM EST

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Disclaimer

The educational activity presented above may involve simulated case-based scenarios. The patients depicted in these scenarios are fictitious and no association with any actual patient is intended or should be inferred.

The material presented here does not necessarily reflect the views of Medscape, LLC, or companies that support educational programming on medscape.org. These materials may discuss therapeutic products that have not been approved by the US Food and Drug Administration and off-label uses of approved products. A qualified healthcare professional should be consulted before using any therapeutic product discussed. Readers should verify all information and data before treating patients or employing any therapies described in this educational activity.

References

Faculty and Disclosures

Faculty

James A. Underberg, MD

Steven Grinspoon, MD

Chair

Peter P. Toth, MD, PhD

Members

Judith A. Aberg, MD

Eliot A. Brinton, MD

Alan S. Brown, MD

Sergio Fazio, MD, PhD

Kevin C. Maki, PhD

Editor

Suzanne Hughes, RN, MSN

CME Reviewer / Nurse Planner

Amy Bernard, MS, BSN, RN-BC

Peer Reviewer

CME / ABIM MOC / CE

5 Things You Need to Know About Statin Selection in Patients With HIV Infection

Target Audience and Goal Statement

Disclosures

Faculty

James A. Underberg, MD

Steven Grinspoon, MD

Chair

Peter P. Toth, MD, PhD

Members

Judith A. Aberg, MD

Eliot A. Brinton, MD

Alan S. Brown, MD

Sergio Fazio, MD, PhD

Kevin C. Maki, PhD

Editor

Suzanne Hughes, RN, MSN

CME Reviewer / Nurse Planner

Amy Bernard, MS, BSN, RN-BC

Peer Reviewer

Accreditation Statements

For Physicians

For Nurses

For Pharmacists

Instructions for Participation and Credit

5 Things You Need to Know About Statin Selection in Patients With HIV Infection