Vachiat A, McCutcheon K, Tsabedze N, et al. HIV and ischemic heart disease. J Am Coll Cardiol. 2017;69:73-82.
Grunfeld C. Dyslipidemia and its treatment in HIV infection. Top HIV Med. 2010;18:112-118.
El-Sadr WM, Mullin CM, Carr A, et al. Effects of HIV disease on lipid, glucose and insulin levels: results from a large antiretroviral-naive cohort. HIV Med. 2005;6:114-121.
Strategies for Management of Antiretroviral Therapy (SMART) Study Group. CD4+ count-guided interruption of antiretroviral treatment. N Engl J Med. 2006;355:2283-2296.
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.
Jacobson TA, Ito MK, Maki KC, et al. National Lipid Association recommendations for patient-centered management of dyslipidemia: part 1 - executive summary. J Clin Lipidol. 2014;8:473-488.
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 August 2018.
Ridker PM, Pradhan A, MacFadyen JG, et al. Cardiovascular benefits and diabetes risks of statin therapy in primary prevention: an analysis from the JUPITER trial. Lancet. 2012;380:565-571.
Aberg JA, Sponseller CA, Ward DJ, et al. Pitavastatin versus pravastatin in adults with HIV-1 infection and dyslipidaemia (INTREPID): 12 week and 52 week results of a phase 4, multicentre, randomised, double-blind, superiority trial. Lancet HIV. 2017;4:e284-e294.
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.
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 August 2018.
Ladapo JA, Richards AK, DeWitt CM, et al. Disparities in the quality of cardiovascular care between HIV-infected versus HIV-uninfected adults in the United States: a cross-sectional study. J Am Heart Assoc. 2017;6:e007107.
Hsue P, Ribaudo H, Deeks SG, et al. Impact of LDMTX on immune activation and endothelial function in treated HIV. 25th Conference on Retroviruses and Opportunistic Infections (CROI). March 4-7, 2018. Boston. Abstract 79.
Tawakol A, Ribaudo H, Isha AE, et al. Impact of methotrexate on arterial inflammation in persons with treated HIV. Conference on Retroviruses and Opportunistic Infections (CROI). March 4-7, 2018. Boston. Abstract 684LB.
Hsue P, Deeks SG, Ishai AE, et al. IL-1β inhibition significantly reduces atherosclerotic inflammation in treated HIV in treated HIV. In: Program and abstracts of the Conference on Retroviruses and Opportunistic Infections, Seattle, Washington, 13-17 February 2016. Abstract 126.
Malvestutto CD, Aberg JA. Challenges of statins in HIV hyperlipidemia. US Endocrinology. 2013;9:157-165.
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.e1.
Silverman MG, Ference BA, Im K, et al. Association between lowering LDL-C and cardiovascular risk reduction among different therapeutic interventions: a systematic review and meta-analysis. JAMA. 2016;316:1289-1297.

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Moderator

Steven Grinspoon, MD

Professor of Medicine
Harvard Medical School
MGH Endowed Chair in Neuroendocrinology and Metabolism
Director
MGH Program in Nutritional Metabolism and Nutrition Obesity Research Center at Harvard
Boston, Massachusetts

Disclosures

Disclosure: Steven Grinspoon, MD, has disclosed the following relevant financial relationships:
Received grants for clinical research from: Gilead Sciences, Inc.; Kowa Company Ltd.; 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.

Panelist

Karen E. Aspry, MD

Assistant Professor of Medicine (Clinical)
Alpert Medical School
Brown University
Director
Lipid and Prevention Program
Lifespan CV Institute
Providence, Rhode Island

Disclosures

Disclosure: Karen E. Aspry, MD, has disclosed the following relevant financial relationships:
Other: Contracted research: Akcea Therapeutics; Amgen Inc.; Ionis Pharmaceuticals, Inc.

Dr Aspry does intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

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

Editors

Joy P. Marko, MS, APN-C, CCMEP

Scientific Director, Medscape, LLC

Disclosures

Disclosure: Joy P. Marko, MS, APN-C, CCMEP, has disclosed no relevant financial relationships.

Kalanethee Paul-Pletzer, PhD

Scientific Director, Medscape, LLC

Disclosures

Disclosure: Kalanethee Paul-Pletzer, PhD, has disclosed no relevant financial relationships.

CME / CE Reviewer

Amy Bernard, MS, BSN, RN-BC, CHCP

Lead Nurse Planner, Medscape, LLC

Disclosures

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

CME / ABIM MOC / CE

Statins and HIV: Tailoring Therapy to Optimize Outcomes

Authors: Steven Grinspoon MD; Karen E. Aspry, MD
CME / ABIM MOC / CE Released: 9/19/2018
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 9/19/2019, 11:59 PM EST

Start Activity

Target Audience and Goal Statement

This activity is intended for cardiologists, infectious disease/HIV specialists, diabetologists, endocrinologists, nurses, nurse practitioners, and pharmacists.

The goal of this activity is to improve cardiovascular outcomes in HIV-infected individuals with the use of appropriate statin therapy.

Upon completion of this activity, participants will be able to:

Have increased knowledge regarding
- Common challenges associated with treatment of dyslipidemia in patients who are HIV positive
- Differences between currently available statins in terms of drug-drug interactions with antiretroviral therapy (ART)
- Coordinated team-based care to promote treatment adherence in patients with dyslipidemia who are HIV positive
Have greater competence related to
- Tailoring lipid-lowering therapy in patients who are HIV positive to optimize cardiovascular disease (CVD) risk reduction

Disclosures

Moderator

Steven Grinspoon, MD

Professor of Medicine
Harvard Medical School
MGH Endowed Chair in Neuroendocrinology and Metabolism
Director
MGH Program in Nutritional Metabolism and Nutrition Obesity Research Center at Harvard
Boston, Massachusetts

Disclosures

Disclosure: Steven Grinspoon, MD, has disclosed the following relevant financial relationships:
Received grants for clinical research from: Gilead Sciences, Inc.; Kowa Company Ltd.; 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.

Panelist

Karen E. Aspry, MD

Assistant Professor of Medicine (Clinical)
Alpert Medical School
Brown University
Director
Lipid and Prevention Program
Lifespan CV Institute
Providence, Rhode Island

Disclosures

Disclosure: Karen E. Aspry, MD, has disclosed the following relevant financial relationships:
Other: Contracted research: Akcea Therapeutics; Amgen Inc.; Ionis Pharmaceuticals, Inc.

Dr Aspry does intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

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

Editors

Joy P. Marko, MS, APN-C, CCMEP

Scientific Director, Medscape, LLC

Disclosures

Disclosure: Joy P. Marko, MS, APN-C, CCMEP, has disclosed no relevant financial relationships.

Kalanethee Paul-Pletzer, PhD

Scientific Director, Medscape, LLC

Disclosures

Disclosure: Kalanethee Paul-Pletzer, PhD, has disclosed no relevant financial relationships.

CME / CE Reviewer

Amy Bernard, MS, BSN, RN-BC, CHCP

Lead Nurse Planner, Medscape, LLC

Disclosures

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

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From Medscape Education Cardiology

CME / ABIM MOC / CE

Statins and HIV: Tailoring Therapy to Optimize Outcomes

Authors: Steven Grinspoon MD; Karen E. Aspry, MDFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CME / ABIM MOC / CE Released: 9/19/2018

Valid for credit through: 9/19/2019, 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

Moderator

Steven Grinspoon, MD

Panelist

Karen E. Aspry, MD

Editors

Joy P. Marko, MS, APN-C, CCMEP

Kalanethee Paul-Pletzer, PhD

CME / CE Reviewer

Amy Bernard, MS, BSN, RN-BC, CHCP

CME / ABIM MOC / CE

Statins and HIV: Tailoring Therapy to Optimize Outcomes

Target Audience and Goal Statement

Disclosures

Moderator

Steven Grinspoon, MD

Panelist

Karen E. Aspry, MD

Editors

Joy P. Marko, MS, APN-C, CCMEP

Kalanethee Paul-Pletzer, PhD

CME / CE Reviewer

Amy Bernard, MS, BSN, RN-BC, CHCP

Accreditation Statements

For Physicians

For Nurses

For Pharmacists

Instructions for Participation and Credit

Statins and HIV: Tailoring Therapy to Optimize Outcomes