Adults With Chronic Inflammatory Disorders and HIV Recommendations for Adults With Chronic Inflammatory Disorders and HIV Referenced studies that support recommendations are summarized in Online Data Supplement 39. COR LOE Recommendations IIa B-NR In adults 40 to 75 years of age with LDL-C have a 10-year ASCVD risk of 7.5% or higher, chronic inflammatory disorders and HIV are risk-enhancing factors and in risk discussion favor moderate-intensity statin therapy or high-intensity statin IIa B-NR In patients with chronic inflammatory disorders or HIV, a fasting lipid profile and assessment of ASCVD risk factors can be useful as a) a guide to benefit of statin therapy and b) for monitoring or adjusting lipid-lowering drug therapy before and 4 to 12 weeks after starting inflammatory disease modifying therapy or antiretroviral IIa B-NR In adults with RA who undergo ASCVD risk assessment with measurement of a lipid profile, it can be useful to recheck lipid values and other major ASCVD risk factors 2 to 4 months after the patient s inflammatory disease has been Synopsis Chronic inflammatory disorders and HIV infection are conditions that often enhance risk. Clinicians should first focus on helping patients with these diagnoses to optimize their lifestyle habits. After a 3- to 6-month trial of lifestyle improvements, including cessation of cigarette smoking, the patient s 10-year ASCVD risk estimate should be reassessed. If the patient s ASCVD risk estimate is 5% over 10 years, it is reasonable to begin moderate-intensity statin therapy. If the pa- tient or clinician remains uncertain about the need for statin therapy or if the patient has had side effects with a statin in the past, a CAC scan can be used to improve risk assessment. 