Pushing statins on “HIV” positive individuals

Because “HIV” drugs affect cholesterol?

This will be a quick post, but I wanted to alert you to the following article, discussing the apparent need to prescribe yet more drugs to the “HIV” positive population in the form of statins. I’ve been seeing more and more about prescribing statins to “HIV” positive individuals, so something is going on. This post won’t discuss the myriad problems with statins; that is a topic for another day. This is disturbing enough already.

This article doesn’t explicitly mention “anti-HIV” drugs as potential culprits for cardiovascular problems, but we know this to be true, especially with “good Truvada.” It will be interesting to see if statins are eventually recommended for those on PrEP.

Statins Can Help Prevent Heart Disease in People with HIV— Are We Looking at the Right Risks?

People with HIV are living longer, thanks to modern medicine, but they still face a higher risk of heart disease. Doctors have long recommended statins—(medication that lowers cholesterol)—to help prevent heart attacks and strokes. Now, new findings from the REPRIEVE trial, presented at the CROI 2025 Conference, show that statins do help.

And why might they face a higher risk of heart disease? It’s not on the list of AIDS defining illnesses. What might be causing this elevated risk? Of course, their conclusion/solution is to pile drug upon drug. This article is pretty lean; there is some discussion about how the typically used test for coronary plaque might not work as well in “HIV” positive individuals; here’s a quick excerpt if you’re interested.

In the general population, doctors often use a coronary artery calcium (CAC) scan to decide who needs statins. This test looks for hardened plaque—the kind that builds up over time and increases the risk of heart attacks.

But at the CROI 2025 conference, Dr. Laura Waters from NHS London asked a key question:

“If I understand correctly, coronary calcium should not be used to decide if people with HIV need statins. In the US, calcium scans are used to help determine who should take them. For people with HIV, you’re saying that soft, non-calcified plaque may be more important. Is that right?”

Dr. Grinspoon confirmed that while CAC scans are useful in the general population, they may not work as well for people with HIV:

“There’s a higher amount of non-calcified plaque in people with HIV. Coronary calcium does predict heart disease, but not as strongly as non-calcified plaque does in this group.”

In other words, the usual test might miss many people with HIV who are actually at high risk.

He also emphasized that anyone with a heart disease risk over 5% should consider statins—regardless of what a calcium scan shows (Grinspoon et al., CROI 2025).

It would certainly be interesting to see some research into why “HIV” positive patients have more of this non-calcified plaque—is it drug-related, or perhaps might it point to something else that is happening in “HIV” disease, since there is really no reasonable explanation for how an alleged retrovirus with a 10+ year latency period prior to its causing severe immunodeficiency is also causing heart disease? This alleged virus has an awful lot of destructive capabilities to fulfill.

Finally:

If you have HIV, keeping your heart healthy is just as important as managing your HIV virus.

This study shows that statins can protect against heart attacks and strokes, even in people who don’t yet have symptoms.

I love that line, even in people who don’t yet have symptoms. It’s all about retention in care. Regardless, this article was unsatisfying, if typical. They conclude: prescribe more drugs. But no one is interested in why or how this phenomenon of cardiovascular trouble is occurring, because it is easier to slap a band-aid in the form of statins on the problem. Unfortunately, that approach will never get us to the truth.

Let me know what you think in the comments.