REPRIEVE final results: What does it mean for guidelines in low‐ and middle‐income countries? Article Swipe
Simiso Sokhela
,
Jennifer Manne‐Goehler
,
Samanta Tresha Lalla‐Edward
,
Mark J. Siedner
,
Mohammed K. Ali
,
Andrew F. Hill
,
Aaloke Mody
,
Anton Pozniak
,
Jeremy Nel
,
François Venter
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1002/jia2.26525
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1002/jia2.26525
Introduction The REPRIEVE study demonstrated significant reductions in major adverse cardiovascular events (MACE) with pitavastatin among people living with HIV (PWH) with low to moderate cardiovascular risk. Most MACE events occurred in higher‐income countries, raising important considerations for similar primary prevention interventions within HIV programmes in low‐ and middle‐income countries (LMICs) as antiretrovirals become safer and as PWH age. Discussion Limited data from Africa and within REPRIEVE suggests that MACE may not be as prevalent among PWH as within other geographies. Consequently, there remain questions about the appropriateness of extrapolating REPRIEVE data to the region and whether it should motivate programmatic implementation on the continent. Moreover, glucose and lipid screening used in REPRIEVE raise concerns about additional resources for similar screening, where there is little existing infrastructure and subsequent treatment. Similarly, questions around funding priorities, and health worker resource allocation for MACE prevention, particularly in the context of competing health priorities and limited health financing, need to be addressed. Newer cardiovascular medications, with cardiac, renal, hepatic, diabetes and weight loss benefits, may have greater promise, although cost remains a major concern. Finally, successful implementation with statins or other proven interventions will be unlikely, unless systemic change within non‐communicable disease health system delivery programmes occurs first. However, HIV programmes and public health systems more generally have shown themselves to be poor at screening and treating other cardiovascular risk factors, including aspects as simple as raised blood pressure, even in high‐income countries, and statins remain grossly under‐prescribed for primary and secondary prevention internationally. Conclusions REPRIEVE turned a spotlight on how ill‐prepared current HIV programmes are to implement the simplest and safest primary care prevention interventions for cardiometabolic disease within LMICs. As data for existing and new interventions become available, HIV delivery systems will need to raise their standard beyond simply prescribing antiretrovirals and taking viral loads.
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- Type
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- Language
- en
- Landing Page
- https://doi.org/10.1002/jia2.26525
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/jia2.26525
- OA Status
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- References
- 33
- Related Works
- 10
- OpenAlex ID
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All OpenAlex metadata
Raw OpenAlex JSON
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https://openalex.org/W4411222259Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1002/jia2.26525Digital Object Identifier
- Title
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REPRIEVE final results: What does it mean for guidelines in low‐ and middle‐income countries?Work title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2025Year of publication
- Publication date
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2025-06-01Full publication date if available
- Authors
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Simiso Sokhela, Jennifer Manne‐Goehler, Samanta Tresha Lalla‐Edward, Mark J. Siedner, Mohammed K. Ali, Andrew F. Hill, Aaloke Mody, Anton Pozniak, Jeremy Nel, François VenterList of authors in order
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/jia2.26525Direct link to full text PDF
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/jia2.26525Direct OA link when available
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Medicine, Low and middle income countries, Environmental health, Developing country, Economic growth, EconomicsTop concepts (fields/topics) attached by OpenAlex
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0Total citation count in OpenAlex
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33Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| citation_normalized_percentile.value | 0.2861746 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | True |