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).
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.
Why this is a question, not a recommendation. Being more specific would need which antiretrovirals you take. That isn't something this tool asks for, so this one stays a question.
Guideline consensusRecommended by the guideline writing committee, drawing on trials plus expert judgement where trials run out.· Class I· checked 2026-09-12
2026 ACC/AHA/Multisociety Guideline on the Management of Dyslipidemia · Class I
“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.