Grant: Project Grant

People living with HIV are at higher risk of heart diseases and strokes, especially as they grow older. This is due to common risk factors such as smoking and diabetes, as well as HIV-related inflammation and long-term effects of treatment. Recently, a large international study called REPRIEVE showed that cholesterol-lowering medications called statins can reduce the risk of serious heart problems by about one-third in people living with HIV who are at low-to-moderate risk of cardiovascular disease. As a result, HIV care guidelines in many countries were updated quickly. However, it is not yet clear whether these new recommendations are being used in everyday HIV care, or whether statins provide the same benefits outside of research studies. This is especially important in Canada, where different tools are used to estimate cardiac risk, and the statin used in the REPRIEVE study is not available. This project will examine how statins for heart disease prevention are being used in routine HIV care in Quebec, and whether they are effective in real-world settings. We will use information from the Quebec HIV Cohort along with provincial health databases. The Quebec HIV Cohort includes clinical data for ~9,000 people actively receiving HIV care, which represents more than half of people diagnosed with HIV in the province. The study will look at the proportion of people with an indication for statin that are prescribed one, whether people continue the statin, how monitoring is done, and whether statins reduce heart attacks and strokes over time. We will also examine differences by sex and gender. Importantly, people living with HIV and healthcare providers will work together to interpret the results and co-develop practical recommendations that fit local needs and healthcare system. The findings will help improve HIV care by supporting safer, more effective, and more acceptable heart disease prevention, and will inform future HIV care in Canada and beyond.