Department of Medical Laboratory Science, Faculty of Health Sciences, University of Buea, Buea, Cameroon.
Department of Medical Laboratory Science, School of Engineering and Applied Sciences, Institut Universitaire de La Côte, Douala, Cameroon.
Sci Rep. 2022 Oct 27;12(1):18121. doi: 10.1038/s41598-022-23102-2.
Statins are hypolipidaemic in human immunodeficiency virus (HIV) positive individuals. However, their effect on all-cause mortality and rate of discontinuation is unclear. We conducted a systematic review to evaluate the impact of statins on all-cause mortality, discontinuation rates, and risk of adverse effects among HIV patients on highly active antiretroviral therapy (HAART). We searched four electronic databases from inception until October 2021 for trials and cohort studies evaluating the effects of statin treatment versus placebo in HIV patients. Forty-seven studies involving 91,594 patients were included. Statins were associated with significantly lower risk of discontinuation (RR, 0.701; 95% CI 0.508-0.967; p = 0.031). The risk of all-cause mortality (RR, 0.994; 95% CI 0.561-1.588; p = 0.827), any adverse effects (RR, 0.780; 95% CI 0.564-1.077; p = 0.131) and, diabetes mellitus (RR, 0.272; 95% CI 0.031-2.393; p = 0.241) with statin treatment were lower but not statistically significant compared to placebo/control. Statin treatment was associated with a trend of higher but statistically insignificant risk of myalgia (RR, 1.341; 95% CI 0.770-2.333; p = 0.299), elevated creatine kinase (RR, 1.101; 95% CI 0.457-2.651; p = 0.830) and liver enzyme activities (RR, 1.709; 95% CI 0.605-4.831; p = 0.312). Clinicians should consider the nocebo effect in the effective management of PLWH on statins, who present with common adverse effects such as myalgia and, elevated levels of creatine kinase and liver enzymes.
他汀类药物在人类免疫缺陷病毒（HIV）阳性个体中具有降血脂作用。然而，它们对全因死亡率和停药率的影响尚不清楚。我们进行了一项系统评价，以评估他汀类药物对接受高效抗逆转录病毒治疗（HAART）的 HIV 患者的全因死亡率、停药率和不良反应风险的影响。我们从建立到 2021 年 10 月在四个电子数据库中搜索了评估他汀类药物治疗与安慰剂在 HIV 患者中的疗效的试验和队列研究。共纳入 47 项研究，涉及 91594 名患者。他汀类药物治疗与停药风险显著降低相关（RR，0.701；95%CI，0.508-0.967；p=0.031）。他汀类药物治疗与全因死亡率（RR，0.994；95%CI，0.561-1.588；p=0.827）、任何不良反应（RR，0.780；95%CI，0.564-1.077；p=0.131）和糖尿病（RR，0.272；95%CI，0.031-2.393；p=0.241）的风险降低相关，但与安慰剂/对照组相比无统计学意义。与安慰剂/对照组相比，他汀类药物治疗与肌痛（RR，1.341；95%CI，0.770-2.333；p=0.299）、肌酸激酶升高（RR，1.101；95%CI，0.457-2.651；p=0.830）和肝酶活性升高（RR，1.709；95%CI，0.605-4.831；p=0.312）的风险升高相关，但无统计学意义。临床医生在管理接受他汀类药物治疗的 PLWH 时应考虑到安慰剂效应，因为他们可能会出现肌痛和肌酸激酶及肝酶水平升高等常见不良反应。
