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Meta-Analysis
. 2018 Jun 5;18(1):258.
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  1 , Chidozie Nduka  2 , Samuel I Watson  3 , Edward J Mills  4 , Andre P Kengne  5   6 , Shabbar S Jaffar  7 , Aileen Clarke  2 , Tahereh Moradi  8 , Anna-Mia Ekström  9   10 , Richard Lilford  3
Affiliations
Meta-Analysis

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

Olalekan A Uthman et al. BMC Infect Dis. .

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.

Keywords: HIV; Mortality; Statin.

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Conflict of interest statement

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Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
PRISMA Flow for study selection
Fig. 2
Fig. 2
Forest plot of association between statins use and all-cause mortality
See this image and copyright information in PMC

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