Statins in HIV QRISK3 — SCE Infectious Diseases MCQ
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Correct answer: A — Yes — statin therapy should be offered per standard NICE CVD prevention guidelines; HIV is included as a QRISK3 variable; a 10-year CVD risk ≥10% warrants statin discussion
Yes. This patient is aged 25–84, has no established CVD, and has a calculated 10-year QRISK3 CVD risk of 12%. Under NICE lipid modification guidance, primary-prevention statin treatment should be offered when the 10-year QRISK3 score is 10% or more, after discussion of lifestyle measures, benefits, harms and patient preference; the usual first-line choice is atorvastatin 20 mg daily. HIV does not exempt patients from standard UK CVD prevention pathways; NICE specifically notes that CVD risk tools may underestimate risk in people treated for HIV, so a score already above the 10% threshold clearly warrants offering statin therapy. Statins are not contraindicated in HIV, but the specific statin and dose should be checked for interactions with the patient’s antiretroviral regimen.
Reference: NICE guideline NG238, Cardiovascular disease: risk assessment and reduction, including lipid modification, published 2023; recommendations 1.1.7, 1.1.10 and 1.6.7. https://www.nice.org.uk/guidance/ng238/chapter/recommendations