Maria Chiara Gatto (1), Francesca Moschella Orsini (1), Ilaria Passarelli (1), Ilaria Ferrari (1), Stefania Cicalini (1), Andrea Antinori (1)
(1) Istituto Nazionale per le Malattie Infettive "Lazzaro Spallanzani" IRCCS
Background: At our dedicated cardiology outpatient clinic, patients with HIVinfection are seen daily. This patient population undergoes routine haematochemical analyses including lipid assessment every six months.Methods: Patients with HIV infection referred to the dedicated cardiologyoutpatient clinic in the period between March and September 2022 wereretrospectively enrolled. For each of these patients, the medical history wascollected and the global cardiovascular risk, lipid assessment (total cholesterol,LDL–C, HDL–C, triglycerides), hypolipidemic therapy (if any) and, in accordancewith the most recent guidelines of the European Society of Cardiology, theachieved LDL target were assessed.Results: 200 patients with mean age 59±15 years with HIV infection onantiretroviral treatment since 20±11 years, 92% male, were enrolled. 58% ofpatients had hypertension, 46% vasculopathy, 44% smoking, 14% diabetes, 10% chronic ischaemic heart disease and 4% previous stroke/TIA. Among thesepatients, 30% had a very high cardiovascular risk, 42% a high cardiovascular risk, 22% a moderate cardiovascular risk and 6% a low cardiovascular risk. Only 60% was on hypolipidemic therapy (statin in 50 per cent of cases and statin+ezetimibe in 10 per cent). Patients with a very high cardiovascular risk had anaverage LDL–cholesterol of 119.2±45.5 mg/dl, patients with a highcardiovascular risk 122.4±43.6 and only 12% of them was found to meet theguideline LDL targets.Conclusions: Assessment and management of cardiovascular risk is crucial in order to reduce mortality and morbidity. In some particular clinical settings such as for patients with chronic infectious diseases (e.g. HIV) more attention must be paid to the LDL–cholesterol target in relation to the individual cardiovascular risk,which is often high or very high. Correct therapeutic management of dyslipidaemia through the use of the fixed statin/ezetimibe combination and themost innovative hypolipidemic therapies such as bempedoic acid, PCSK9inhibitors, and inclisiran is the keystone in order to achieve the target.
