Statins are hypolipidaemic in human immunodeficiency virus (HIV) positive individuals. However, their effect on all-cause mortality and rate of discontinuation is unclear. The aim of this systematic review was to evaluate the impact of statins on all-cause mortality, discontinuation rates, and risk of adverse effects among HIV patients on highly active antiretroviral therapy (HAART). We searched four electronic databases from inception until October 2021 for trials and cohort studies evaluating the effects of statin treatment versus placebo in HIV patients. Forty-seven studies involving 91,594 patients were included. Statins were associated with significantly lower risk of discontinuation (RR, 0.701; 95% CI 0.508–0.967; p = 0.031). The risk of all-cause mortality (RR, 0.994; 95% CI 0.561–1.588; p = 0.827), any adverse effects (RR, 0.780; 95% CI 0.564–1.077; p = 0.131) and, diabetes mellitus (RR, 0.272; 95% CI 0.031–2.393; p = 0.241) with statin treatment were lower but not statistically significant compared to placebo/control. Statin treatment was associated with a trend of higher but statistically insignificant risk of myalgia (RR, 1.341; 95% CI 0.770–2.333; p = 0.299), elevated creatine kinase (RR, 1.101; 95% CI 0.457–2.651; p = 0.830) and liver enzyme activities (RR, 1.709; 95% CI 0.605–4.831; p = 0.312). In conclusion, clinicians should consider the nocebo effect in the effective management of PLWH on statins, who present with common adverse effects such as myalgia and, elevated levels of creatine kinase and liver enzymes.

Njeodo Vigny was a Ph.D. candidate in Chemical Pathology at the University of Buea in Cameroon. He completed his master’s degree in 2016 in Chemical Pathology with focus on the evaluation of cardiovascular risk factors in HIV/AIDS patients receiving HAART. He has various publications, in reputable and prestigious journals e.g., Scientific Reports, and scientific posters at both national and international conferences. He has been serving as a reviewer for the HIV/AIDS - Research and Palliative Care journal since 2023. He is currently a laboratory consultant for a laboratory information management system project in the KB SAP Consulting department of Groupe Kedibuild in Douala, Cameroon. He is also serving as a part-time medical laboratory science instructor at the University Institute of the Coast in Douala, Cameroon.