Metabolic syndrome among people living with HIV in Ethiopia: a systematic review and meta-analysis

Abstract

Background Human Immuno-deficiency Virus (HIV) infection and antiretroviral therapy (ART) can cause metabolic disorders such as lipodystrophy, dyslipidemia, and insulin resistance, all of which are symptoms of metabolic syndrome (MetS). In Ethiopia, despite the existence of the primary studies, there was no pooled study conducted to summarize the country-level MetS among people living with HIV (PLHIV). Therefore, this study aims to estimate the pooled prevalence of MetS among PLHIV in Ethiopia. Methods A systematic search was conducted to retrieve studies on the prevalence of MetS among PLHIV in Ethiopia from PubMed, Google Scholar, Science Direct, Web of Sciences, HINARI, and other relevant sources. A random-effects model was used to estimate the MetS in this study. The overall variation between studies was checked by the heterogeneity test (I2). The Joanna Briggs Institute (JBI) quality appraisal criteria were used to assess the quality of the studies. The summary estimates were presented with forest plots and tables. Publication bias was checked with the funnel plot and Egger’s regression test. Results Overall, 366 articles were identified and evaluated using the PRISMA guidelines, with 10 studies meeting the inclusion criteria included in the final analysis. The pooled prevalence of MetS among PLHIV in Ethiopia was 21.7% (95% CI:19.36–24.04) using National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III) and 29.91% (95% CI: 21.54–38.28) using International Diabetes Federation (IDF) criteria. The lowest and highest prevalence of MetS were 19.14% (95%CI: 15.63–22.64) and 25.6% (95%CI: 20.18–31.08) at Southern Nation and Nationality People Region (SNNPR) and Addis Ababa, respectively. There was no statistical evidence of publication bias in both NCEP-ATP III and IDF pooled estimates. Conclusion MetS was common among PLHIV in Ethiopia. Therefore, optimizing regular screening for MetS components and promoting a healthy lifestyle is suggested for PLHIV. Furthermore, more study is contributory to identify the barriers to implementing planned interventions and meeting recommended treatment goals. Trial registration: The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO): CRD42023403786.