Mass General Investigators Identify Metabolic Risk Factors for New-Onset Diabetes Among People with HIV Using Data from Large, Global Trial

Data from the REPRIEVE trial suggest there is only a minimal increased risk of diabetes with statins among people with HIV, and in specific, limited groups

Researchers from Massachusetts General Hospital, a founding member of the Mass General Brigham healthcare system, have found evidence that diabetes develops predominantly among people with HIV with metabolic risk factors such as prediabetes and elevated body mass index. The findings were consistent for participants treated with pitavastatin and those treated with placebo, suggesting that statins had a minimal effect on risk of new-onset diabetes. The findings are published in Annals of Internal Medicine.

“The results overall are very reassuring,” said Steven Grinspoon, MD, Chief, Metabolism Unit, MGH Endowed Chair in Neuroendocrinology and Metabolism. “They suggest that there's only a minimal increased risk of diabetes with statins among people with HIV, and in specific, limited groups. This is important because guidelines have now expanded to recommend statins for people with HIV with a CVD risk score greater than 5%, meaning that many of the global HIV population will be on them.”

The global trial, REPRIEVE (Randomized Trial to Prevent Vascular Events in HIV,) showed that the statin, pitavastatin calcium, prevented major adverse cardiovascular events (MACE) among people with HIV but was associated with a modest increase in new-onset diabetes. Diabetes is an important consideration for PWH, who may have unique risk mechanisms related to antiretroviral therapy and other factors. Data from REPRIEVE demonstrated that statins can be given safely to PWH and lead to an overall reduction in MACE, including among those with metabolic risk of developing diabetes.

Authorship: In addition to Grinspoon, Mass General Brigham authors include Kathleen V. Fitch (MGH), Markella V. Zanni (MGH), Marissa R. Diggs (MGH), Arijeet K. Gattu (MGH), Samir K. Gupta (MGH), Michael T. Lu (MGH), and Jennifer Manne-Goehler (BWH).

Funding: National Heart, Lung, and Blood Institute of the National Institutes of Health.