Your situation (severe hypercholesterolemia short-circuits the risk score) HIV, age 40–75
hiv-statinNo one has reached this rule yetStatin on the diagnosis alone; LDL-C <100; check interactions with antiretrovirals
No clinician has signed off this rule yet. It reflects our reading of the guidelines cited below, which has not been independently checked.
Word for word, as generated for the example person below. Figures in the text are theirs.
Living with HIV is an independent reason to be on a statin between 40 and 75 — ask which one, because the answer depends on your antiretrovirals. Target LDL-C below 100 mg/dL (and non-HDL-C below 130).
Expert guidelinesOfficial guidelines recommend it, based on trials plus expert judgment.
HIV carries excess cardiovascular risk that standard equations under-estimate, driven by chronic inflammation as well as by some antiretroviral regimens, and the 2026 guideline made it an independent indication in this age band. Which statin matters more here than almost anywhere else: several antiretrovirals raise statin levels substantially, and pitavastatin and rosuvastatin are commonly preferred for that reason. This tool does not ask which antiretrovirals you take, so it will not pick one for you — take the indication to whoever manages your HIV care and let them choose.
ACC/AHA (US)
Graded for people aged 40 to 75 on stable antiretroviral therapy.
2026 ACC/AHA/Multisociety Guideline on the Management of Dyslipidemia · Recommendation behind this rule · class and level read from the guideline tables on 2026-09-30
ESC (Europe)
Statin therapy for people with HIV aged 40 or older, whatever the estimated risk or LDL-C.
2025 ESC/EAS focused update on dyslipidaemias · Recommendation tables · class and level read from the guideline tables on 2026-09-30
Why this is a question. It would need which antiretrovirals you take. This tool doesn't ask for that, so it stays a question.
2026 ACC/AHA/Multisociety Guideline on the Management of Dyslipidemia · Class 1 · Level B-R
“Living with HIV” — an illustrative profile, not a real user.
Asked after: No known cardiovascular disease
Then asks: Coronary artery calcium (CAC) score? (further testing beyond basic labs)
Cited by the recommendations above.
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Runs in lib/engine/lipidPathway.ts as hiv-statin.