Prevalence of metabolic syndrome in human immunodeficiency virus - infected patients from the South-West region of Cameroon, using the adult treatment panel III criteria

Abstract

BackgroundSeveral studies have reported that the metabolic syndrome (MS) is more common in subjects with HIV infection than in HIV-negative individuals. HIV infection and the use of Highly Active Antiretroviral Therapy (HAART) have been shown to predispose HIV-infected persons to MS. In this study, we report the prevalence of MS in Cameroonian HIV-infected subjects receiving different combinations of HAART as well as HIV patients who have never received antiretroviral drugs.MethodsIn this cross-sectional study, 173 treated and untreated HIV-infected out-patients (aged 18–70 years) managed at the Buea and Limbe Regional Hospitals and 50 seronegative individuals (controls) were recruited after obtaining their consent. Ethical approval for this study was obtained from the National Ethics Committee of Cameroon. Metabolic syndrome prevalence was examined using the U.S. National Cholesterol Education Program Adult Treatment Panel III (ATPIII) criteria. Data was analyzed using SPSS® (Statistical Package for the Social Sciences, SPSS Inc., Chicago, IL, USA) version 16. Statistical significance was set at p < 0.05.Results and discussionThe prevalence of MS among the HIV patients was 15.6% (27/173) and 8% (4/50) among the controls and the difference was significant (p = 0.022). MS was more prevalent in HIV-infected patients on HAART than in ART-naive patients and seronegative individuals. Overall, the prevalence of MS was significantly higher (p = 0.003) in females (28/153; 18.3%) than in males (3/70; 4.3%). The patients on first-line drugs demonstrated the highest MS prevalence (15/62; 24.2%) followed by the ART-naïve group of patients (7/61; 11.5%) and the lowest prevalence was among the patients on protease inhibitors (5/50; 10%). Patients on the drug combination Lamivudine/Stavudine/Nevirapine had the highest prevalence of MS (50%).ConclusionsIn this study, HAART but not HIV disease plays a significant role in the development of MS. The metabolic complications as a result of treatment with HAART may predispose HIV patients to developing cardiovascular diseases and diabetes, in spite of improvements in morbidity and mortality conferred by immune reconstitution as a result of HAART treatment.

HIV treatment is associated with a twofold higher probability of raised triglycerides: pooled analyses in 21 023 individuals in sub-Saharan Africa

“…Further, available evidence consistently shows higher rates of hyperglyceridaemia among HIV-infected individuals receiving ART compared with untreated HIV-positive individuals and HIV-negative individuals [43,45,46]. Estimates of the prevalence of hypertriglyceridemia of between 14% and 42% have been reported among individuals receiving ART [43,45,46]. The heterogeneity is perhaps explained by underlying differences between populations in addition to differences in the duration of ART use -for example, comorbidities, socioeconomic factors and healthcare systems.…”

“…This variation likely reflects differences in study design as well as potential real differences between populations. Further, available evidence consistently shows higher rates of hyperglyceridaemia among HIV-infected individuals receiving ART compared with untreated HIV-positive individuals and HIV-negative individuals [43,45,46]. Estimates of the prevalence of hypertriglyceridemia of between 14% and 42% have been reported among individuals receiving ART [43,45,46].…”

“…Estimates of raised TG prevalence ranging from 5% to 20% have been reported in rural East Africa and urban West Africa, respectively [42][43][44]. This variation likely reflects differences in study design as well as potential real differences between populations.…”

Antiretroviral therapy-induced insulin resistance and oxidative deoxy nucleic acid damage in human immunodeficiency virus-1 patients

“…However, long-term toxicity is becoming recognized, treated patients are at a significant risk for a number of diseases typically associated with older age, including insulin resistance (IR), cardiovascular disease, osteoporosis, cancer, neurocognitive impairment, and frailty, particularly when therapy contains protease inhibitors (PIs). [12345]…”

“…In India, where there is a genetic predisposition to IR and cardiovascular risk, this impact may be significant. [515161718192021] IR plays a key role in the pathogenesis of the metabolic syndrome and is frequently detected among HIV patients on ART. [222324] Biochemistry of IR: pancreatic b-cells release insulin in response to hyperglycemia, stimulating muscle and adipose tissue to store sugar, and blocking the liver from releasing glucose into circulation.…”