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

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 t...

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Main Authors: Florian Voit, Sven Breitschwerdt, Annamaria Balogh, Helen Bidner, Silvia Egert- Schwender, Christoph Boesecke, Laura Wagner, Eva Wolf, Christoph D. Spinner
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:HIV Research & Clinical Practice
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Online Access:http://dx.doi.org/10.1080/25787489.2025.2535352
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author Florian Voit
Sven Breitschwerdt
Annamaria Balogh
Helen Bidner
Silvia Egert- Schwender
Christoph Boesecke
Laura Wagner
Eva Wolf
Christoph D. Spinner
author_facet Florian Voit
Sven Breitschwerdt
Annamaria Balogh
Helen Bidner
Silvia Egert- Schwender
Christoph Boesecke
Laura Wagner
Eva Wolf
Christoph D. Spinner
author_sort Florian Voit
collection DOAJ
description 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.
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spelling doaj-art-e6fc9124b4e14871ae1fdcde93c371fa2025-08-20T03:44:50ZengTaylor & Francis GroupHIV Research & Clinical Practice2578-74702025-12-0126110.1080/25787489.2025.25353522535352Cardiovascular risk and achievement of target levels in low-density lipoprotein cholesterol in people living with HIV: insights from the DUALIS studyFlorian Voit0Sven Breitschwerdt1Annamaria Balogh2Helen Bidner3Silvia Egert- Schwender4Christoph Boesecke5Laura Wagner6Eva Wolf7Christoph D. Spinner8Department of Clinical Medicine, – Clinical Department for Internal Medicine II, TUM School of Medicine and Health, University Medical Center, Technical University of MunichDepartment of Internal Medicine I, University Hospital BonnMUC ResearchTUM School of Medicine and Health, Münchner Studienzentrum (MSZ), University Medical Center, Technical University of MunichTUM School of Medicine and Health, Münchner Studienzentrum (MSZ), University Medical Center, Technical University of MunichDepartment of Internal Medicine I, University Hospital BonnDepartment of Clinical Medicine, – Clinical Department for Internal Medicine II, TUM School of Medicine and Health, University Medical Center, Technical University of MunichMUC ResearchDepartment of Clinical Medicine, – Clinical Department for Internal Medicine II, TUM School of Medicine and Health, University Medical Center, Technical University of MunichObjectives 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.http://dx.doi.org/10.1080/25787489.2025.2535352hivcardiovascular disease risklipid managementldl, germany
spellingShingle Florian Voit
Sven Breitschwerdt
Annamaria Balogh
Helen Bidner
Silvia Egert- Schwender
Christoph Boesecke
Laura Wagner
Eva Wolf
Christoph D. Spinner
Cardiovascular risk and achievement of target levels in low-density lipoprotein cholesterol in people living with HIV: insights from the DUALIS study
HIV Research & Clinical Practice
hiv
cardiovascular disease risk
lipid management
ldl, germany
title Cardiovascular risk and achievement of target levels in low-density lipoprotein cholesterol in people living with HIV: insights from the DUALIS study
title_full Cardiovascular risk and achievement of target levels in low-density lipoprotein cholesterol in people living with HIV: insights from the DUALIS study
title_fullStr Cardiovascular risk and achievement of target levels in low-density lipoprotein cholesterol in people living with HIV: insights from the DUALIS study
title_full_unstemmed Cardiovascular risk and achievement of target levels in low-density lipoprotein cholesterol in people living with HIV: insights from the DUALIS study
title_short Cardiovascular risk and achievement of target levels in low-density lipoprotein cholesterol in people living with HIV: insights from the DUALIS study
title_sort cardiovascular risk and achievement of target levels in low density lipoprotein cholesterol in people living with hiv insights from the dualis study
topic hiv
cardiovascular disease risk
lipid management
ldl, germany
url http://dx.doi.org/10.1080/25787489.2025.2535352
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