Assessment of metabolic syndrome in HIV-infected individuals

Theengh, Diki P; Yadav, Pushpa; Jain, Amit; Nandy, Partha

doi:10.4103/ijstd.ijstd_55_16

Cited by 12 publications

(3 citation statements)

References 10 publications

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“…Metabolic syndrome was common among ART-experienced adults in Zambia, with a prevalence of 26.3% (95% CI 23.9–29.1), and it appears to be associated with inflammatory markers, sociodemographic, anthropometric, clinical, and laboratory characteristics. Other investigators have also observed high prevalences of MetS in similar groups in Ethiopia, [ 21 ] Cameroon [ 22 ] India, [ 23 , 24 ] Thailand, [ 25 ] and Portugal. [ 26 ] However, those studies reported a range of prevalences which could be partly explained by differences in sociodemographics, MetS definitions, and ART regimens.…”

Section: Discussionmentioning

confidence: 86%

Metabolic syndrome in Zambian adults with human immunodeficiency virus on antiretroviral therapy

et al. 2021

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Metabolic syndrome (MetS) is a constellation of factors including hypertension, abdominal obesity, dyslipidemia, and insulin resistance that separately and together significantly increase risk for cardiovascular disease (CVD) and diabetes. In sub-Saharan Africa, with a substantial burden of human immunodeficiency virus (HIV) and increasing prevalence of CVD and diabetes, there is a paucity of epidemiological data on demographic, laboratory, and clinical characteristics associated with MetS among people with HIV (people with human [PWH]). Therefore, this study aimed to determine the burden and factors influencing MetS in antiretroviral therapy (ART)-experienced individuals in Zambia. We collected cross-sectional demographic, lifestyle, anthropometric, clinical, and laboratory data in a cohort of ART-experienced (on ART for ≥6 months) adults in 24 urban HIV treatment clinics of Zambia between August, 2016 and May, 2020. MetS was defined as having ≥3 of the following characteristics: low high density lipoprotein cholesterol (HDL-c) (<1.0 mmol/L for men, <1.3 for women), elevated waist circumference (≥94 cm for men, ≥80 cm for women), elevated triglycerides (≥1.7 mmol/L), elevated fasting blood glucose (≥5.6 mmol/L), and elevated blood pressure (BP) (systolic BP ≥130 or diastolic BP ≥85 mm Hg). Virological failure (VF) was defined as HIV viral load ≥1000 copies/mL. The following statistical methods were used: Chi-square test, Wilcoxon rank-sum test, and multivariable logistic regression. Among 1108 participants, the median age (interquartile range [IQR]) was 41 years (34, 49); 666 (60.1%) were females. The prevalence of MetS was 26.3% (95% confidence interval [CI] 23.9–29.1). Age (adjusted odds ratio [OR] 1.07; 95% CI 1.04–1.11), female sex (OR 3.02; 95% CI 1.55–5.91), VF (OR 1.98; 95% CI 1.01–3.87), dolutegravir (DTG)-based regimen (OR 2.10; 95% CI 1.05–4.20), hip-circumference (OR 1.03; 95% CI 1.01–1.05), T-lymphocyte count (OR 2.23; 95% CI 1.44–3.43), high-sensitivity C-reactive protein (hsCRP) (OR 1.14; 95% CI 1.01–1.29), and fasting insulin (OR 1.02; 95% CI 1.01–1.04) were significantly associated with MetS. Metabolic syndrome was highly prevalent among HIV+ adults receiving ART in Zambia and associated with demographic, clinical, anthropometric, and inflammatory characteristics. The association between MetS and dolutegravir requires further investigation, as does elucidation of the impact of MetS on ART outcomes in sub-Saharan African PWH.

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Section: Discussionmentioning

confidence: 86%

Metabolic syndrome in Zambian adults with human immunodeficiency virus on antiretroviral therapy

et al. 2021

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“…MetS prevalence in PLWH is commonly evaluated by the Adult Treatment Panel III (ATP III) and International Diabetes Federation (IDF) criteria. Using these criteria, it was shown that the prevalence of MetS is comparable in PLWH versus HCs, but higher in PLWH under ART compared with ART-naïve PLWH [84,85]. Overall, patients with MetS were older, HIV-infected for a longer time, and presented with a higher body mass index (BMI).…”

Section: Non-aids Co-morbidities In Plwhmentioning

confidence: 99%

Immune Activation, Inflammation, and Non-AIDS Co-Morbidities in HIV-Infected Patients under Long-Term ART

Zicari

Sessa

Cotugno

et al. 2019

Viruses

341

243

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Despite effective antiretroviral therapy (ART), people living with HIV (PLWH) still present persistent chronic immune activation and inflammation. This condition is the result of several factors including thymic dysfunction, persistent antigen stimulation due to low residual viremia, microbial translocation and dysbiosis, caused by the disruption of the gut mucosa, co-infections, and cumulative ART toxicity. All of these factors can create a vicious cycle that does not allow the full control of immune activation and inflammation, leading to an increased risk of developing non-AIDS co-morbidities such as metabolic syndrome and cardiovascular diseases. This review aims to provide an overview of the most recent data about HIV-associated inflammation and chronic immune exhaustion in PLWH under effective ART. Furthermore, we discuss new therapy approaches that are currently being tested to reduce the risk of developing inflammation, ART toxicity, and non-AIDS co-morbidities.

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“…Significant associations were observed with type of ART and low CD4 cell counts. Theengh D.et al, Estrada V et al, and Drelichowska J. et al also showed higher metabolic and body fat abnormality in HIV-infected adults specially those who were taking ART and HIV-associated lipodystrophy was found to be associated with several host, disease, and drug factors [6][7][8]. While prevalence of lipoatrophy increased with the use of indinavir and stavudine (now out of use and banned in many countries), lipoaccumulation was associated with duration as well as type of ART specially protease inhibitors.…”

Section: Discussionmentioning

confidence: 94%

Non-Alcoholic fatty liver disease and metabolic syndrome in patients with HIV/AIDS and its correlation with antiretroviral therapy and severity of disease

Gupta,

Tyagi,

Mathews

et al. 2023

SL J. Med.

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Introduction: Metabolic syndrome (MetS) and Non-alcoholic fatty liver disease (NAFLD) are two major causes of morbidity in chronic HIV infected patients on antiretroviral therapy (ART). This study was done on HIV infected individuals by comparing ART naive patients with patients on different ART regimens and evaluating the effect of ART on Metabolic syndrome and NAFLD.Method: It was a cross-sectional observational study done on 120 HIV infected individuals in a tertiary care centre in New Delhi. All cases with hypertension, diabetes, chronic kidney or liver disease, thyroid disorders or on any drugs except ART were excluded. The risk markers for metabolic syndrome were assessed and compared within groups on different ART regimens.Results: Metabolic syndrome and NAFLD were found to be significantly more in cases on ART as compared to ART naïve cases. Metabolic syndrome was found to be associated with type of ART protease inhibitors (ATV/r)> nonucleoside reverse transcriptase inhibitors (NNRTI) > no ART] and low CD4 cell counts (p=0.01). In those patients who were on ART, these parameters were found to be more in those on second line ART [i.e., protease inhibitor (PI)(ATV/r) based regimens] as compared to those on first line ART, [i.e., nonnucleoside reverse transcriptase inhibitors (NNRTI) based regimen]. 15% of cases on 2nd line ART (group C) had MetS as compared to 12.5% in those on 1st line ART (group B) and nil in ART naïve cases (group A). One third (34%) of all 120 cases were found to have NAFLD. A significantly higher number of cases (45%) in group C had NAFLD as compared to 32.5% in group B and 25% in group A respectively. Insulin resistance and metabolic risk markers were also significantly higher in cases on ART as compared to ART naïve.Conclusions: In HIV patients, the use of antiretroviral therapy (ART) is linked to an increase in the prevalence of metabolic risk factors, including insulin resistance, lipoatrophy and dystrophy, dyslipidaemia, and abnormalities of fat distribution. Although care of Opportunistic infections and recently CVD has received a lot of attention, it is equally important to address the metabolic abnormalities such as metabolic syndrome and NAFLD brought on by ART.

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Assessment of metabolic syndrome in HIV-infected individuals

Cited by 12 publications

References 10 publications

Metabolic syndrome in Zambian adults with human immunodeficiency virus on antiretroviral therapy

Metabolic syndrome in Zambian adults with human immunodeficiency virus on antiretroviral therapy

Immune Activation, Inflammation, and Non-AIDS Co-Morbidities in HIV-Infected Patients under Long-Term ART

Non-Alcoholic fatty liver disease and metabolic syndrome in patients with HIV/AIDS and its correlation with antiretroviral therapy and severity of disease

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