A study of effect of anti-retroviral therapy regimen on metabolic syndrome in people living with HIV/AIDS: Post hoc analysis from a tertiary care hospital in western India

Sashindran, VK; Singh, Anchit Raj

doi:10.1016/j.dsx.2021.03.003

Cited by 5 publications

(6 citation statements)

References 32 publications

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“…Tis observation agrees with the fndings of Labhardt et al who reported that, in South African HIV patients, those on AZTbased regimens had increased likelihood of MetS compared to those on TDF-based regimens [32]. In contrast to our fndings, Sashindran and Singh reported that TDF-based regimens rather increase the likelihood of MetS in Indian HIV patients [5]. Te AZT-based regimen has been shown to cause oxidative damage, a major mechanistic pathway of MetS and CVDs, through the induction of mitochondrial dysfunction by inhibition of DNA polymerase-c activity [33].…”

Section: Mets and Cartsupporting

confidence: 91%

“…Te widespread availability and accessibility of combination antiretroviral therapy (cART) in low-middleincome countries have dramatically decreased the mortality attributable to HIV infection in the past decade [4]. Now, PLWHs live longer and become more susceptible to chronic diseases, especially cardiovascular diseases (CVDs) [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Protease inhibitor-based regimens are not commonly used among most PLWHs in Ghana [14]. It has been reported that these cART regimens are associated with MetS and CVDs, but these study reports are from patients in the developed countries [11,15] and the Asian population [5]. Tere is no study reporting the association between cART regimens and MetS in the Ghanaian population.…”

Section: Introductionmentioning

confidence: 99%

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Metabolic Syndrome and Combination Antiretroviral Therapy in HIV Patients in Periurban Hospital in Ghana: A Case-Control Study

Dzudzor

Essel

Musah

et al. 2023

AIDS Research and Treatment

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Background. There is an increasing prevalence of cardiovascular diseases (CVDs) and risk factors in HIV patients as the levels of AIDS-related mortality and morbidity decrease. Metabolic syndrome (MetS) is the accumulation of various CVD risk factors that predict the occurrence of CVDs. We investigated the prevalence of MetS and associated risk factors in HIV patients treated with combination antiretroviral therapy (cART), cART-naïve HIV patients, and non-HIV controls. Methods. In a case-control design, 158 cART-treated HIV patients, 150 cART-naïve HIV patients, and 156 non-HIV controls were recruited from a periurban hospital in Ghana. A structured questionnaire was used to collect data on demography, lifestyle, and medication. Anthropometric indices and blood pressure were measured. Fasting blood samples were collected to measure the plasma levels of glucose, lipid profile, and CD4+ cells. The presence of MetS was defined using the joint scientific statement criteria. Results. The prevalence of MetS was higher in cART-treated HIV patients compared with cART-naïve HIV patients and non-HIV controls (57.3% vs. 23.6% vs. 19.2% and p < 0.001 , respectively). MetS was associated with cART-treated HIV patients (odds ratio (95% CI) = 7.24 (3.41–15.39) and p < 0.001 ), cART-naïve HIV patients (2.04 (1.01–4.15), p = 0.048 ), and female gender (2.42 (1.39–4.23) and p = 0.002 ). In cART-treated HIV patients, those on zidovudine (AZT)-based regimens were associated with increased likelihood (3.95 (1.49–10.43) and p < 0.006 ), while those on tenofovir (TDF)-based had decreased likelihood (0.32 (0.13–0.8) and p = 0.015 ) of having MetS. Conclusion. In our study population, there was a high prevalence of MetS in cART-treated HIV patients compared to cART-naïve HIV patients and non-HIV controls. HIV patients on AZT-based regimens had an increased likelihood of having MetS, while those on TDF-based regimens had a reduced likelihood of having MetS.

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Section: Mets and Cartsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Metabolic Syndrome and Combination Antiretroviral Therapy in HIV Patients in Periurban Hospital in Ghana: A Case-Control Study

Dzudzor

Essel

Musah

et al. 2023

AIDS Research and Treatment

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“…A study from India, before the introduction of dolutegravir in 2019, reported a prevalence of metabolic syndrome in PLWH of 21.3%, with the highest prevalence in people on a PI-based regimen with a tenofovir backbone [37 ▪ ]. A study from Ethiopia had the same findings: metabolic syndrome was present in 23.5% of all HIV positive participants.…”

Section: Antiretroviral Therapy and Metabolic Changesmentioning

confidence: 87%

Cardiovascular toxicity of contemporary antiretroviral therapy

Vos

Venter

2021

Current Opinion in HIV and AIDS

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Purpose of review HIV treatment has evolved since the introduction of antiretroviral therapy (ART) in the 1990s. Earlier treatment strategies, and the introduction of integrase inhibitors in preferred first-line ART have fundamentally changed cardiovascular side effects due to HIV infection and ART. This review provides an update on cardiovascular toxicity of contemporary ART. Recent findingsCardiovascular disease (CVD) risk, including heart failure, is still increased in people living with HIV (PLWH). Exposure to older antiretrovirals, including stavudine and zidovudine, still impact on CVD risk through persistent changes in body fat distribution years after discontinuation. Protease inhibitors (PI) and efavirenz have associated metabolic disturbances and increased risk of CVD, although use is decreasing worldwide. Integrase inhibitors and CCR5 antagonists seem to have negligible immediate CVD toxicity. Weight gain on newer antiretrovirals including integrase inhibitors is a reason for concern. SummaryCVD risk should be monitored carefully in PLWH who were exposed to first generation ART, efavirenz or to PIs. Registries should capture ART use and CVD events to stay informed on actual clinical risk in the current era of rapid initiation on integrase inhibitor-based ART.

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“…In addition to chronic neuroinflammation, HIV is associated with increased prevalence of metabolic disorders such as dyslipidemia and diabetes, which are also more prevalent as people age, all of which are risk factors for AD and vascular dementia. ART itself has been implicated as a contributor to metabolic disorders, which are more prevalent among ART-treated women and older persons (Sashindran & Singh, 2021). The metabolic syndrome has been linked to self-report of apathy and executive dysfunction (Pope et al, 2020) as well as to deficits in learning, fine motor skills, and executive function in PWH, with diabetes and elevated triglycerides as the factors most strongly linked with worse overall neuropsychological performance (Yu et al, 2019).…”

Section: Demographic Influences In Handmentioning

confidence: 99%