HHS panel recommend statins for adults with HIV at risk for cardiovascular disease

Embargoed for release until 5:00 p.m. ET on Monday 26 May 2025   

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Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.   
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1. HHS panel recommend statins for adults with HIV at risk for cardiovascular disease

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-24-03564

Editorial: https://www.acpjournals.org/doi/10.7326/ANNALS-25-01463

URL goes live when the embargo lifts             

In February 2024, the U.S. Department of Health and Human Services Panel for the Use of Antiretroviral Agents in Adults and Adolescents with HIV (ARV Guidelines Panel), in collaboration with the American College of Cardiology (ACC), the American Heart Association (AHA), and the HIV Medicine Association (HIVMA), developed statin therapy recommendations for people with HIV (PWH). These recommendations were informed by the results of the REPRIEVE (Randomized Trial to Prevent Vascular Events in HIV) study. A summary of the recommendations relevant to physicians is published in Annals of Internal Medicine.

PWH are more at risk for many aging-related diseases, including atherosclerotic cardiovascular disease (ASCVD). The REPRIEVE study was a phase 3, global, randomized controlled trial of oral pitavastatin versus placebo for the prevention of ASCVD in PWH aged 40 to 75 years at low to intermediate risk based on 10-year risk estimates. Compared with placebo, pitavastatin was associated with a 36% reduction in MACE. These findings informed the ARV panel to recommend moderate-intensity statin therapy as the primary prevention among PWH aged 40 to 75 years with low to intermediate 10-year ASCVD risk. The panel also strongly recommends initiating statin therapy among people with a 10-year ASCVD risk score of 5% or higher. For PWH with a 10-year ASCVD risk score below 5%, the panel favored statin therapy but also recommended that patient– clinician risk discussions consider HIV-related factors than can increase ASCVD risk. Among PWH younger than 40 years, decisions to initiate statin therapy should be individualized and based on risk factors and familial health history. The panel recommends the use of at least moderate- intensity statins including pitavastatin, 4 mg daily; atorvastatin, 20 mg daily; or rosuvastatin, 10 mg daily. The authors note that future research is needed to better understand the absolute risk for ASCVD and other nonischemic CVD manifestations in people with HIV.

Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To contact corresponding author Craig Beavers, PharmD, please email cjbeav2@uky.edu.

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2. Less than 15% of cancer survivors with alcoholism initiate treatment in the year after diagnosis

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-24-02679

URL goes live when the embargo lifts             

A retrospective cohort study estimated the cumulative incidence of FDA-approved medications for alcohol use disorder (MAUD) and initiation of psychosocial therapy among cancer survivors. The researchers found that only 14.3% of cancer survivors with AUD initiated any AUD treatment in the one year after AUD diagnosis. The low incidence of AUD treatment could be attributed to low provider knowledge of MAUDs as well as the stigma associated with AUD, prompting the need for further research to explore barriers to AUD treatment. The study is published in Annals of Internal Medicine.

Researchers from the University of Texas at Austin and colleagues analyzed claims data from a nationwide sample of 25 million people with employer-sponsored commercial and Medicare supplemental insurance between January 2011 and December 2021. Of 6.6 million cancer survivors identified from the sample, the researchers included 71,875 adults who received a new AUD diagnosis in the cohort. They followed them from their AUD diagnosis date until they initiated an FDA-approved MAUD or psychosocial therapy, disenrolled or lost health care coverage, or reached the end of the 1-year follow-up period. The 1-year cumulative incidence of any AUD treatment initiation was 14.3%. Psychosocial therapy initiation was 12.6%, however, MAUD initiation was much smaller at 2.8%. Less than 1% of participants received both psychosocial and MAUD therapies within a year after AUD diagnosis. Female cancer survivors and those younger than 65 years were more likely to initiate any AUD treatment. The researchers hope future research can explore the system-level and patient-level barriers to AUD treatment.

Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To contact corresponding author Anton L.V. Avanceña, PhD, please email Nicholas Nobel at nobel@utexas.edu.

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3. Unconditional cash transfers may increase breastfeeding but little to no effect seen on other postpartum outcomes in diverse populations

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-24-03495

Editorial: https://www.acpjournals.org/doi/10.7326/ANNALS-25-01462

URL goes live when the embargo lifts             

A systematic review of studies reporting associations between unconditional cash transfers (UCTs) and postpartum outcomes in the United States found that UCTs increase breastfeeding in diverse populations and settings but have no impact on postpartum mood in low-income populations. The researchers note there is little available evidence on UCTs and postpartum outcomes in the US, and they suggest enhanced collaboration between social scientists and clinicians to gather the evidence needed to inform policies and practices that improve maternal health outcomes, especially in low-income populations. The review is published in Annals of Internal Medicine.

Researchers from Boston Medical Center and colleagues analyzed findings from 11 reports from six studies examining the effect of UCTs on postpartum outcomes in the US. The researchers focused their review on UCTs (which included tax credits and refunds, Supplemental Security Income disability benefits, and direct cash transfers) because they allow recipients to determine where the money is spent, which may be most effective at addressing individualized social determinants of health. The researchers divided postpartum outcomes into five categories: infant or childcare, reproductive health, substance use, other mental health outcomes, and other outcomes. Of the six studies, four of them were quasi-experimental (QE) observational analyses of UCT social programs in the US, all of which were designed to increase income but not designed specifically for postpartum people. The most common outcomes evaluated among the six studies were infant or childcare outcomes and postpartum mental health outcomes. The researchers found high strength of evidence that UCTs result in more breastfeeding, possibly because UCTs allow for more parental childcare by enabling mothers to have flexible work schedules. However, there was no association between UCTs and use of nonparental childcare (day cares, nannies, etc.). UCTs have little to no effect on postpartum mood, specifically depression symptoms. The authors suggest continued attention to the UCT recipient experience is essential to understand how UCTs affect mental health. The review found a low certainty of evidence for all other associations between UCTs and postpartum outcomes due to insufficient evidence. The review highlights evidence gaps on the effect of financial assistance on postpartum outcomes and emphasizes the need for more research to inform policies and practices that improve maternal health outcomes.

Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To contact corresponding author Mara E. Murray Horwitz, MD, MPH, please email mara.murrayhorwitz@bmc.org.

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