Li Yanping, Wang Zhandi, Xia Haimei, Zhang Ju
School of Chemistry, Biology and Environment, Institute of Biology and Environmental Engineering, Yuxi Normal University, Yuxi, China.
Center of Chinese Medicine, Yunnan Institute of Traditional Chinese Medicine, Kunming, China.
Front Med (Lausanne). 2021 Nov 8;8:769740. doi: 10.3389/fmed.2021.769740. eCollection 2021.
Possible influences of statin therapy on the risk of cardiovascular events, cancer, and all-cause mortality in people living with HIV (PLWH) remain unclear. We performed a meta-analysis to systematically evaluate the efficacy of statin in PLWH. Relevant cohort studies were retrieved via a search of the Medline, the Embase, and the Web of Science databases until June 14, 2021. The data were combined with a random-effects model by incorporating the between-study heterogeneity. A total of 12 multivariate cohort studies with 162,252 participants were eligible for the meta-analysis and 36,253 (22.3%) of them were statin users. Pooled results showed that statin use was independently related to a reduced mortality risk in PLWH [adjusted risk ratio (RR): 0.56, 95% CI: 0.44 to 0.72, < 0.001, = 41%]. In addition, results of the meta-analysis showed that statin use was not significantly associated with a reduced risk of cardiovascular events in PLWH compared to the statin non-users (RR: 1.14, 95% CI: 0.80 to 1.63, = 0.48, = 42%). However, statin use was significantly related to a reduced risk of cancer in PLWH (RR: 0.73, 95% CI: 0.58 to 0.93, = 0.009, = 49%). Sensitivity analyses by excluding one study at a time showed consistent results. No significant publication biases were observed. Statin use is associated with reduced all-cause mortality in PLWH. In addition, statin use is related to a reduced risk of cancer, although the risk of cardiovascular events seems not significantly affected.
他汀类药物治疗对HIV感染者（PLWH）发生心血管事件、癌症和全因死亡风险的潜在影响仍不明确。我们进行了一项荟萃分析，以系统评估他汀类药物在PLWH中的疗效。通过检索Medline、Embase和Web of Science数据库，获取截至2021年6月14日的相关队列研究。通过纳入研究间异质性，采用随机效应模型对数据进行合并。共有12项多变量队列研究、162252名参与者符合荟萃分析的条件，其中36253名（22.3%）为他汀类药物使用者。汇总结果显示，使用他汀类药物与PLWH死亡风险降低独立相关[调整风险比（RR）：0.56，95%置信区间（CI）：0.44至0.72，P<0.001，I² = 41%]。此外，荟萃分析结果显示，与未使用他汀类药物者相比，使用他汀类药物与PLWH发生心血管事件风险降低无显著关联（RR：1.14，95%CI：0.80至1.63，P = 0.48，I² = 42%）。然而，使用他汀类药物与PLWH患癌风险降低显著相关（RR：0.73，95%CI：0.58至0.93，P = 0.009，I² = 49%）。每次排除一项研究的敏感性分析显示结果一致。未观察到显著的发表偏倚。使用他汀类药物与PLWH全因死亡率降低相关。此外，使用他汀类药物与患癌风险降低相关，尽管心血管事件风险似乎未受到显著影响。
