Cholesterol Screening and Statin Prescription is Low Among HIV-Infected Patients on Protease-Inhibitor Regimens in Botswana

M. Mosepele1, *, V. Letsatsi2, L. Mokgatlhe3, F.P. Hudson4, R. Gross5
1 Faculty of Medicine, University of Botswana, Gaborone, Botswana
2 Princess Marina Hospital, Gaborone, Botswana
3 Department of Biostatistics, University of Botswana, Gaborone, Botswana
4 Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA
5 Pearlman School of Medicine, Philadelphia, Pennsylvania, USA / Botswana-UPenn Partnership, Gaborone, Botswana

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© 2017 Mosepele et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Faculty of Medicine, University of Botswana, P/Bag 022, Gaborone, Botswana; Tel: 00267 355 5589; E-mails:,



Little is known about the use of statin for cardiovascular disease (CVD) risk reduction among HIV-infected patients on protease inhibitors (PI`s) in sub-Saharan Africa (SSA).


Cholesterol screening and statin use were retrospectively assessed among HIV-infected participants on PI`s between 2008 and 2012 at a large urban HIV clinic in Botswana.


Proportion of participants screened per year was calculated and statin indication was assessed using atherosclerosis CVD (ASCVD) and Framingham risk (FRS) scores as of the year 2012 guidelines.


Cholesterol screening ranged between 19% and 30% per year (2008-2011) but increased to 80% after study enrollment. The rate of hypercholesterolemia (> 5.0 mmol/L) was 31% in 2012. Fewer than 1% participants were on statin therapy but 14.3% and 9.4% had statins indicated by ASCVD and FRS respectively.


The high proportion of participants indicated for, but not prescribed statins highlights a substantial gap in the care to reduce CVD risk among these patients.

Keywords: Cholesterol, HIV-1 infection, Statin, Protease inhibitor, Cardiovascular risk, Sub-Saharan Africa.