Prevalence of Metabolic Syndrome Among Antiretroviral-Naive and Antiretroviral-Experienced HIV-1 Infected Thai Adults

Abstract

Metabolic syndrome (MS), a group of interrelated risk factors for cardiovascular diseases (CVD) and type 2 diabetes, has been increasingly reported among HIV-infected patients. Data on the prevalence and risk factors for MS among HIV-1 infected Thai adults are limited. The study collected cross-sectional data from 580 HIV-1 infected adults-46.2% were men and 71% were antiretroviral therapy (ART)-experienced. The majority (78.8%) of them used non-nucleoside reverse transcriptase inhibitor-based regimens. Data on lipid profiles, fasting blood glucose, CD4 count, HIV RNA, antiretroviral therapy (ART), anthropometry, food intake, and exercise were recorded. MS was defined using American Heart Association/National Heart Lung and Blood Institute criteria. Overall prevalence of MS was 22.2%; 15.9% in ART-naïve group vs. 24.9% in ART-experienced group, p = 0.018. Significant risk factors for MS in multivariate analyses included age ≥35 years (odds ratio, OR, 4.2, 95%CI 1.6-11.0, p = 0.004), high cholesterol (OR 4.7, 95%CI 1.7-12.9, p = 0.002), and living outside Bangkok (OR 4.2, 95%CI 1.6-10.8, p = 0.003) in the ART-naïve group, and female gender (OR 1.7, 95%CI 1.0-2.8, p = 0.05), lipodystrophy (OR 1.8, 95%CI 1.0-3.0, p = 0.032), high cholesterol (OR 1.9, 95%CI 1.1-3.1, p = 0.015), and food insecurity (OR 1.8, 95%CI 1.0-3.3, p = 0.05) in the ART-experienced group. All variables, except for female gender in the ART-experienced group, remained significantly associated with MS in a model where lipodystrophy was excluded. We concluded that MS was common among HIV-1-infected Thai adults. As HIV-infected patients get older, early screening and intervention, such as ART modification to avoid lipodystrophy, may reduce MS and CVD-related morbidities and mortalities in long-term care.

Impact of antiretroviral therapy on serum lipoprotein levels and dyslipidemias: A systematic review and meta-analysis

“…There were 37,110 HIV-infected patients in total, with females representing approximately 28%. Thirty-one studies (61%) were conducted in low-and middleincome countries with the highest number of studies (n = 8) reported in India [22,27,29,30,45,47,59,61], followed by six studies in Nigeria [24,31,34,36,50,54], and four studies each in Brazil [23,32,41,44], Norway [15,16,55,62], and USA [17,39,40,53]. Nonetheless, studies conducted in high-income countries were generally larger in size (n = 30,120 participants), compared with studies conducted in low-and middleincome countries (n = 7488).…”

Evidence of increased blood pressure and hypertension risk among people living with HIV on antiretroviral therapy: a systematic review with meta-analysis

“…A total of 573 abstracts and 17 full texts, including seven duplicate records, were excluded, leaving 39 eligible observational studies. [5][6][7][8]15,16, Thirty of these included studies were cross-sectional surveys, 5,16,[18][19][20][21][22][23][24][25][26]28,[31][32][33][34][35][36][37][39][40][41][42][44][45][46]48,49 whereas the other nine were cohort studies. A total of 44 903 HIV-infected patients (28% females) from 21 countries were included in our analyses, with significantly more study participants from high-income countries compared with low-and middle-income countries (89% versus 11%).…”

“…[5][6][7][8] In addition, no systematic evidence has provided comprehensive estimates of the impact of ART exposure on blood pressure levels and hypertension risk. We therefore set out to address this gap in the current body of evidence by performing a systematic review and meta-analysis to compare blood pressure levels and hypertension risk between HIV-infected patients naive and exposed to ART.…”

People living with HIV on ART have accurate perception of lipodystrophy signs: a cross-sectional study

“…The usual methods applied in the diagnosis vary from self-perception [6, 12], health professional [12] or physical examination [7], skinfolds measurements [8], or even imaging assessment such as dual emission X-ray absorptiometry (DEXA) [7, 9], CT [9], or MRI [10] for confirmation of fat distribution changes [10, 11]. Although several methods have been developed, there is no gold standard for characterization of LA and LH, or mixed forms [2, 13].…”