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

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dc.contributor.authorUthman, Olalekan A
dc.contributor.authorNduka, Chidozie
dc.contributor.authorWatson, Samuel I
dc.contributor.authorMills, Edward J
dc.contributor.authorKengne, Andre P
dc.contributor.authorJaffar, Shabbar S
dc.contributor.authorClarke, Aileen
dc.contributor.authorMoradi, Tahereh
dc.contributor.authorEkström, Anna-Mia
dc.contributor.authorLilford, Richard
dc.date.accessioned2018-06-19T09:22:38Z
dc.date.available2018-06-19T09:22:38Z
dc.date.issued2018-06-05
dc.date.updated2018-06-10T03:38:18Z
dc.description.abstractBackground 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.
dc.identifier.apacitationUthman, O. A., Nduka, C., Watson, S. I., Mills, E. J., Kengne, A. P., Jaffar, S. S., ... Lilford, R. (2018). Statin use and all-cause mortality in people living with HIV: a systematic review and meta-analysis. <i>BMC Infectious Diseases</i>, http://hdl.handle.net/11427/28262en_ZA
dc.identifier.chicagocitationUthman, Olalekan A, Chidozie Nduka, Samuel I Watson, Edward J Mills, Andre P Kengne, Shabbar S Jaffar, Aileen Clarke, Tahereh Moradi, Anna-Mia Ekström, and Richard Lilford "Statin use and all-cause mortality in people living with HIV: a systematic review and meta-analysis." <i>BMC Infectious Diseases</i> (2018) http://hdl.handle.net/11427/28262en_ZA
dc.identifier.citationUthman, O. A., Nduka, C., Watson, S. I., Mills, E. J., Kengne, A. P., Jaffar, S. S., ... & Lilford, R. (2018). Statin use and all-cause mortality in people living with HIV: a systematic review and meta-analysis. BMC infectious diseases, 18(1), 258.
dc.identifier.ris TY - Journal Article AU - Uthman, Olalekan A AU - Nduka, Chidozie AU - Watson, Samuel I AU - Mills, Edward J AU - Kengne, Andre P AU - Jaffar, Shabbar S AU - Clarke, Aileen AU - Moradi, Tahereh AU - Ekström, Anna-Mia AU - Lilford, Richard AB - 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. DA - 2018-06-05 DB - OpenUCT DP - University of Cape Town J1 - BMC Infectious Diseases LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - Statin use and all-cause mortality in people living with HIV: a systematic review and meta-analysis TI - Statin use and all-cause mortality in people living with HIV: a systematic review and meta-analysis UR - http://hdl.handle.net/11427/28262 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12879-018-3162-1
dc.identifier.urihttp://hdl.handle.net/11427/28262
dc.identifier.vancouvercitationUthman OA, Nduka C, Watson SI, Mills EJ, Kengne AP, Jaffar SS, et al. Statin use and all-cause mortality in people living with HIV: a systematic review and meta-analysis. BMC Infectious Diseases. 2018; http://hdl.handle.net/11427/28262.en_ZA
dc.language.isoen
dc.publisherBioMed Central
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rights.holderThe Author(s).
dc.sourceBMC Infectious Diseases
dc.source.urihttps://bmcinfectdis.biomedcentral.com/
dc.subject.otherStatin
dc.subject.otherHIV
dc.subject.otherMortality
dc.titleStatin use and all-cause mortality in people living with HIV: a systematic review and meta-analysis
dc.typeJournal Article
uct.type.filetypeText
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