DALLAS—Statins appear to have immunomodulatory and anti-inflammatory effects and appear to reduce cancer risk. A new study sought to determine if that also is the case with HIV patients, who experience chronic inflammation and immune activation.
An article in the journal AIDS looked at whether statin exposure is associated with decreased cancer and mortality risk among people with HIV (PWH) and uninfected people. The cholesterol-lowering medications were found to be most effective in reducing non-Hodgin lymphoma risks in PWH.1
VA North Texas Healthcare System-led researchers propensity score matched cohorts of statin-exposed and unexposed patients from 2002-2017 in the Veterans Aging Cohort Study (VACS), which has cancer registry linkage and detailed pharmacy data.
The study team focused on statin use for all cancers, microbial cancers (associated with bacterial or oncovirus coinfection), nonmicrobial cancers and mortality. Included in the propensity score-matched sample of 47,940 were 23,970 veterans who had initiated statins, 31% of them PWH.
Researchers noted that Incident cancers were diagnosed in 1,160 PWH and 2,116 uninfected patients, while death was reported in 1,667 (7.0%) statin-exposed, and 2,215 (9.2%) unexposed patients.
Results indicated that statin use was associated with 24% decreased risk of microbial associated cancers (HR 0.76; 95% CI 0.69-0.85) but was not associated with nonmicrobial cancer risk (HR 1.00; 95% CI 0.92-1.09). Furthermore, the authors reported, statin use was associated with 33% lower risk of death overall (HR 0.67; 95% CI 0.63-0.72).
“Results were similar in analyses stratified by HIV status, except for non-Hodgkin lymphoma where statin use was associated with reduced risk (HR 0.56; 95% CI 0.38-0.83) for PWH, but not for uninfected (p-interaction = 0.012),” the researchers wrote,
“In both PWH and uninfected, statin exposure was associated with lower risk of microbial, but not non-microbial cancer incidence, and with decreased mortality,” according to the authors.
- Bedimo RJ, Park LS, Shebl F, Sigel K, Rentsch CT, Crothers K, Rodriguez-Barradas MC, Goetz MB, Butt AA, Brown ST, Gibert C, Justice AC, Tate JP. Statin exposure and risk of cancer in people with and without HIV infection. 2020 Nov 11. doi: 10.1097/QAD.0000000000002748. Epub ahead of print. PMID: 33181533.
