Discussion
This study is a double-blind and placebo-controlled trial. The main purpose of this study is to evaluate the effect of atorvastatin administration on CIMT changes in statin naïve virally suppressed HIV-infected patients without any comorbidities with stable ART and CMV seropositivity. To our knowledge this is the first study which is conducted in a population of this kind.A study of statin-intervention with a 48 week follow-up comes with challenges and considerable limitations. First, the possibility of missed visits by study patients. Second, managing the follow-up of treatment and evaluation because this study involves multi-disciplinary specialists. Our solutions to avoid these problems is assigning a research assistant to regularly and preemptively remind patients and specialist teams to attend or carry out scheduled procedures by phone or message. If the patients cannot be contacted, the research assistant will check the schedule of antiretroviral collection at the administration desk. Another challenge arises from the Covid-19 pandemic. We have faced the difficulty of conducting direct monitoring due to the implementation of social restrictions. Many HIV-infected patients using delivery services to get their antiretroviral drugs in order to maintain their medications. We also conduct online monitoring and maintain study drug medications using delivery services. When it comes to procedural examination, physical barriers are provided along with personal protective equipment.In sum, if the results as agree with our hypothesis, statin administration may be useful to prevent negative cardiovascular outcomes, especially the carotid intima medial thickness among virally suppressed HIV-infected patients and CMV seropositivity.