Cardiovascular risk and achievement of target levels in low-density lipoprotein cholesterol in people living with HIV: insights from the DUALIS study.

IF 1.8 4区医学 Q3 INFECTIOUS DISEASES

HIV Research & Clinical Practice Pub Date : 2025-12-01 Epub Date: 2025-07-23 DOI:10.1080/25787489.2025.2535352

Florian Voit, Sven Breitschwerdt, Annamaria Balogh, Helen Bidner, Silvia Egert-Schwender, Christoph Boesecke, Laura Wagner, Eva Wolf, Christoph D Spinner

{"title":"Cardiovascular risk and achievement of target levels in low-density lipoprotein cholesterol in people living with HIV: insights from the DUALIS study.","authors":"Florian Voit, Sven Breitschwerdt, Annamaria Balogh, Helen Bidner, Silvia Egert-Schwender, Christoph Boesecke, Laura Wagner, Eva Wolf, Christoph D Spinner","doi":"10.1080/25787489.2025.2535352","DOIUrl":null,"url":null,"abstract":"Objectives: This post-hoc evaluation of the DUALIS study aimed to examine cardiovascular risk and the achievement of low-density lipoprotein cholesterol (LDL-C) targets in a virologically suppressed cohort of people living with HIV in Germany.Methods: Baseline cardiovascular risk was assessed using the European Society of Cardiology (ESC)-Systematic COronary Risk Evaluation 2 (SCORE2)/SCORE2-Older Persons (OP) and the current ESC guideline-recommended LDL-C targets among participants aged ≥40 years in the DUALIS study. Risk categorization was based on the ESC-SCORE2/SCORE2-OP results and the presence of specific comorbidities indicative of high risk and very high risk of CVD. Participants were enrolled between July 2015 and June 2017.Results: The use of lipid-lowering therapy (LLT) was low in the DUALIS study, with 12 out of 188 participants (6%) receiving the treatment. The median ESC-SCORE2/SCORE2-OP was 5.0%. Overall, 92 participants (49%) had low-to-moderate CVD risk, 77 (41%) high risk, and 19 (10%) very high risk. Only one participant in the high-risk group and none in the very high-risk group met the guideline-recommended LDL-C targets. Even when using the less stringent LDL-C targets valid at the time of data collection (2016 ESC guideline), only 19.7% of the high-risk and none of the very high-risk participants met these targets. In addition, a strong correlation regarding the estimated CVD risk was observed between the D:A:D (R) and ESC SCORE2/SCORE2-OP scores (r = 0.95).Conclusions: The achievement of guideline-recommended LDL-C targets was low in the high- and very high-CVD-risk groups in the DUALIS study, reflecting low utilization of LLT in clinical practice.","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"26 1","pages":"2535352"},"PeriodicalIF":1.8000,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"HIV Research & Clinical Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/25787489.2025.2535352","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/23 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives: This post-hoc evaluation of the DUALIS study aimed to examine cardiovascular risk and the achievement of low-density lipoprotein cholesterol (LDL-C) targets in a virologically suppressed cohort of people living with HIV in Germany.

Methods: Baseline cardiovascular risk was assessed using the European Society of Cardiology (ESC)-Systematic COronary Risk Evaluation 2 (SCORE2)/SCORE2-Older Persons (OP) and the current ESC guideline-recommended LDL-C targets among participants aged ≥40 years in the DUALIS study. Risk categorization was based on the ESC-SCORE2/SCORE2-OP results and the presence of specific comorbidities indicative of high risk and very high risk of CVD. Participants were enrolled between July 2015 and June 2017.

Results: The use of lipid-lowering therapy (LLT) was low in the DUALIS study, with 12 out of 188 participants (6%) receiving the treatment. The median ESC-SCORE2/SCORE2-OP was 5.0%. Overall, 92 participants (49%) had low-to-moderate CVD risk, 77 (41%) high risk, and 19 (10%) very high risk. Only one participant in the high-risk group and none in the very high-risk group met the guideline-recommended LDL-C targets. Even when using the less stringent LDL-C targets valid at the time of data collection (2016 ESC guideline), only 19.7% of the high-risk and none of the very high-risk participants met these targets. In addition, a strong correlation regarding the estimated CVD risk was observed between the D:A:D (R) and ESC SCORE2/SCORE2-OP scores (r = 0.95).

Conclusions: The achievement of guideline-recommended LDL-C targets was low in the high- and very high-CVD-risk groups in the DUALIS study, reflecting low utilization of LLT in clinical practice.

查看原文本刊更多论文

艾滋病毒感染者的心血管风险和低密度脂蛋白胆固醇目标水平的实现：来自DUALIS研究的见解

目的：这项对DUALIS研究的事后评估旨在检查德国HIV感染者病毒学抑制队列中的心血管风险和低密度脂蛋白胆固醇（LDL-C）目标的实现。方法：基线心血管风险评估采用欧洲心脏病学会(ESC)-系统性冠状动脉风险评估2 (SCORE2)/SCORE2-老年人（OP）和当前ESC指南推荐的LDL-C目标在年龄≥40岁的受试者中进行。风险分类基于ESC-SCORE2/SCORE2-OP结果以及是否存在指示心血管疾病高风险和极高风险的特定合并症。参与者在2015年7月至2017年6月期间注册。结果：在DUALIS研究中，降脂疗法（LLT）的使用率很低，188名参与者中有12人（6%）接受了治疗。中位ESC-SCORE2/SCORE2-OP为5.0%。总体而言，92名参与者（49%）有低至中度心血管疾病风险，77名（41%）有高风险，19名（10%）有非常高风险。高危组中只有一名参与者达到指南推荐的LDL-C目标，高危组中没有一名参与者达到指南推荐的LDL-C目标。即使使用在数据收集时有效的较不严格的LDL-C目标（2016 ESC指南），只有19.7%的高风险参与者和无高危参与者达到这些目标。此外，在D: a:D (R)和ESC SCORE2/SCORE2- op评分之间观察到估计的CVD风险有很强的相关性（R = 0.95）。结论：在DUALIS研究中，cvd高危组和高危组的LDL-C达标率较低，反映了LLT在临床实践中的低使用率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

HIV Research & Clinical Practice Multiple-

CiteScore

2.90

自引率

6.20%

发文量