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: https://creativecommons.org/licenses/by/4.0/legalcode. 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: mosepelemosepele@gmail.com, mosepele.mosepele@mopipi.ub.bw


Abstract

Background:

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).

Objective:

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.

Methods:

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.

Results:

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.

Conclusion:

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.