{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T10:45:34Z","timestamp":1791888334165,"version":"4.3.4"},"reference-count":15,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100013885","name":"Kementerian Kesihatan Malaysia","doi-asserted-by":"publisher","award":["NMRR 23-01983-QSM"],"award-info":[{"award-number":["NMRR 23-01983-QSM"]}],"id":[{"id":"10.13039\/501100013885","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Assoc Provid AIDS Care"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Optimal statin initiation strategies for people living with HIV (PLHIV) remain uncertain. We evaluated whether the D:A:D reduced (D:A:Dr) model improves primary prevention statin initiation decisions among Malaysian PLHIV compared with non-risk-based strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study followed statin-na\u00efve PLHIV adults from an infectious diseases centre over five years for incident cardiovascular events. Decision curve analysis compared the net benefit of a D:A:Dr-guided strategy against four alternatives: LDL-cholesterol \u22653.0 mmol\/L, age \u226540 years, treat-all, and treat-none.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 5,741 PLHIV, 48.9% were moderate-to high-risk. The 5-year event rate was 2.0%, ranging from 0.5% (low-risk) to 8\u20139% (high-risk). D:A:Dr-guided strategy yielded superior net benefit at &gt;2% - 10% threshold probabilities. Age \u226540 years lost benefits as thresholds increased whereas LDL\u2013cholesterol\u2013based strategy offered minimal utility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>D:A:Dr risk-based statin initiation offers superior clinical utility at &gt;2% to 10% threshold probabilities, enabling targeted, resource-efficient prescribing in resource-constrained settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259582261492596","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T18:17:28Z","timestamp":1791569848000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk-Guided Statin Initiation in People Living with HIV: Clinical Utility of a Cardiovascular Risk Prediction Model in a Malaysian Cohort"],"prefix":"10.1177","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6755-920X","authenticated-orcid":false,"given":"Wen Yea","family":"Hwong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoon Shien","family":"Teh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim Heng","family":"Tay","sequence":"additional","affiliation":[{"name":"Sungai Buloh Hospital"},{"name":"Ministry of Health Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.033369"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2304146"},{"key":"e_1_3_7_4_2","unstructured":"Recommendations for the Use of Statin Therapy as Primary Prevention of Atherosclerotic Cardiovascular Disease in People With HIV. 2024. https:\/\/clinicalinfo.hiv.gov\/en\/guidelines\/hiv-clinical-guidelines-adult-and-adolescent-arv\/statin-therapy-people-hiv. Accessed 28th April 2026."},{"key":"e_1_3_7_5_2","unstructured":"BHIVA rapid guidance on the use of statins for primary prevention of cardiovascular disease in people living with HIV v2. 2024. https:\/\/bhiva.org\/rapid-guidance\/bhiva-rapid-guidance-on-the-use-of-statins-for-primary-prevention-of-cardiovascular-disease\/Accessed 28th April 2026."},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(25)00047-5"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2025.108211"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s41512-019-0064-7"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/2047487315579291"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.13044"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X06295361"},{"key":"e_1_3_7_12_2","volume-title":"Malaysian Consensus Guidelines on Antiretroviral Therapy","author":"Malaysian Society of HIV Medicine","year":"2022","unstructured":"Malaysian Society of HIV Medicine. Malaysian Consensus Guidelines on Antiretroviral Therapy; 2022."},{"key":"e_1_3_7_13_2","volume-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2021","unstructured":"R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing; 2021."},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2023.5661"},{"key":"e_1_3_7_15_2","volume-title":"Statistics on Causes of Death Malaysia 2024","author":"Department of Statistics Malaysia","unstructured":"Department of Statistics Malaysia. Statistics on Causes of Death Malaysia 2024. https:\/\/www.dosm.gov.my\/portal-main\/release-content\/statistics-on-causes-of-death-malaysia-2024. Accessed 27th March 2025."},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.1515\/dx-2025-0113"}],"container-title":["Journal of the International Association of Providers of AIDS Care (JIAPAC)"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259582261492596","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23259582261492596","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259582261492596","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T09:53:45Z","timestamp":1791885225000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23259582261492596"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":15,"alternative-id":["10.1177\/23259582261492596"],"URL":"https:\/\/doi.org\/10.1177\/23259582261492596","relation":{},"ISSN":["2325-9582","2325-9582"],"issn-type":[{"value":"2325-9582","type":"print"},{"value":"2325-9582","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"article-number":"23259582261492596"}}