ASSOCIATED RISK FACTORS AND PREVALENCE OF METABOLIC SYNDROME IN PEOPLE WHO ARE LIVING WITH HIV AND ARE ON ANTIRETYROVIRAL TREATMENT

Biljana Jovan Petreska; Milena Stevanovic; Irena Kondova Topuzovska; Velimir Saveski; Elena Arsik

Biljana Jovan Petreska University Clinic for Infectious Diseases and Febrile Conditions, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, North Macedonia
Milena Stevanovic University Clinic for Infectious Diseases and Febrile Conditions, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, North Macedonia
Irena Kondova Topuzovska University Clinic for Infectious Diseases and Febrile Conditions, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, North Macedonia
Velimir Saveski University Clinic for Infectious Diseases and Febrile Conditions, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, North Macedonia
Elena Arsik University Clinic for Infectious Diseases and Febrile Conditions, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, North Macedonia

Abstract

The extended life expectancy of people living with HIV infection increases the risk of metabolic syndrome (MS). To assess the prevalence of MS, the association of triple regimen antiretroviral therapy (ART) and the role of the chronic inflammatory process caused by the HIV virus with the onset of MS. A prospective cross-sectional study was conducted on 141 HIV infected adult patients with confirmed HIV infection who regularly receive ART at the University Clinic for infectious diseases and febrile conditions in Skopje. In all patients, the presence of MS was determined according to the criteria of the National Cholesterol Education Program Adult Treatment Panel ATP III (NCEP ATPIII) 2005. The statistical software SPSS (ver. 23.0; IBM, SPSS, USA) was used for statistical analysis. The prevalence of MS in persons with HIV infection in RNM was 17.96%. The group of patients with MS were significantly older and had significantly higher Body Mass Index and greater waist circumference (28.82 ± 4.6 kg/m²vs 23.91 ± 3.6 kg/m²p<0.0001) and (101.04 ± 12.4 vs 87.19 ± 9.8cm,p<0.0001), respectively. Treatment of patients with ART did not show a significant difference in the group with and without MS. There is a significant difference regarding the frequency of IL 6 (p=0.012). Aging and increasing Body Mass Index are significant risk factors in the developing of MS in persons with HIV infection who are on ART treatment.

Key words: metabolic syndrome, HIV infection, antiretroviral treatment.

References

1.Wu PY, Hung CC, Liu WC, Hsieh CY, Sun HY, Lu CL, Wu H, Chien KL. Metabolic syndrome among HIV-infected Taiwanese patients in the era of highly active antiretroviral therapy: prevalence and associated factors. J Antimicrob Chemother. 2012 Apr;67(4):1001-9. doi:10.1093/jac/dkr558.
2.Tesfaye DY, Kinde S, Medhin G, Megerssa YC, Tadewos A, Tadesse E, Shimelis T. Burden of metabolic syndrome among HIV-infected patients in Southern Ethiopia. Diabetes Metab Syndr. 2014 Apr-Jun;8(2):102-7. doi:10.1016/j.dsx.2014.04.008.
3.World Health Organization. HIV data and statistics. 22 July 2024.
4.European AIDS Clinical Society. EACS guidelines version 12.0 October 2023.
5.Ojong E, Iya B, Djeufouata J, Ndeh F, Nsonwu A, Njongang V, Etukudo M, Usoro C, Ekpo J. Metabolic syndrome and its components among HIV/AIDS patients on Antiretroviral Therapy and ART-Naïve Patients at the University of Calabar Teaching Hospital, Calabar, Nigeria. Afr Health Sci. 2022 Mar;22(1):410-417. doi:10.4314/ahs.v22i1.50.
6.Osoti A, Temu TM, Kirui N, Ngetich EK, Kamano JH, Page S, Farquhar C, Bloomfield GS. Metabolic Syndrome Among Antiretroviral Therapy-Naive Versus Experienced HIV-Infected Patients Without Preexisting Cardiometabolic Disorders in Western Kenya. AIDS Patient Care STDS. 2018 Jun;32(6):215-222. doi:10.1089/apc.2018.0052.
7.Nguyen KA, Peer N, Mills EJ, Kengne AP. A Meta-Analysis of the Metabolic Syndrome Prevalence in the Global HIV-Infected Population. PLoS One. 2016 Mar 23;11(3):e0150970. doi:10.1371/journal.pone.0150970.
8.Masenga SK, Elijovich F, Koethe JR, Hamooya BM, Heimburger DC, Munsaka SM, Laffer CL, Kirabo A. Hypertension and Metabolic Syndrome in Persons with HIV. Curr Hypertens Rep. 2020 Sep 3;22(10):78. doi:10.1007/s11906-020-01089-3.
9.Hamooya BM, Mulenga LB, Masenga SK, Fwemba I, Chirwa L, Siwingwa M, Halwiindi H, Koethe JR, Lipworth L, Heimburger DC, Musonda P, Mutale W. Metabolic syndrome in Zambian adults with human immunodeficiency virus on antiretroviral therapy: Prevalence and associated factors. Medicine (Baltimore). 2021 Apr 9;100(14):e25236. doi:10.1097/MD.0000000000025236.
10.Jemal M. A review of dolutegravir-associated weight gain and secondary metabolic comorbidities. SAGE Open Med. 2024 Jun 13;12:20503121241260613. doi:10.1177/20503121241260613.
11.Iannone V, Passerotto RA, Lamanna F, Steiner RJ, Lombardi F, Salvo PF, Dusina A, Farinacci D, Borghetti A, Di Giambenedetto S, Ciccullo A. Changes in Metabolic Profile in PLWHIV Switching to Doravirine-Based Regimen. Viruses. 2023 Apr 25;15(5):1046. doi:10.3390/v15051046.
12.Naidu S, Ponnampalvanar S, Kamaruzzaman SB, Kamarulzaman A. Prevalence of Metabolic Syndrome Among People Living with HIV in Developing Countries: A Systematic Review. AIDS Patient Care STDS. 2017 Jan;31(1):1-13. doi:10.1089/apc.2016.0140.
13.U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute. National High Blood Pressure Education Program. NIH Publication No. 03-5233. December 2003.
14.Hsue PY, Hunt PW, Schnell A, Kalapus SC, Hoh R, Ganz P, Martin JN, Deeks SG. Role of viral replication, antiretroviral therapy, and immunodeficiency in HIV-associated atherosclerosis. AIDS. 2009 Jun 1;23(9):1059-67. doi:10.1097/QAD.0b013e32832b514b.
15.Malindisa E, Balandya E, Njelekela M, Kidenya BR, Francis F, Mmbaga BT, Dika H, Lyamuya E, Sunguya B, Bartlett J, PrayGod G. Metabolic syndrome among people living with HIV on antiretroviral therapy in Mwanza, Tanzania. BMC Endocr Disord. 2023 Apr 21;23(1):88. doi:10.1186/s12902-023-01340-3.
16.Lazzaro A, Bianchini D, Gentilini Cacciola E, Mezzaroma I, Falciano M, Andreoni C, Fimiani C, Santinelli L, Maddaloni L, Bugani G, Ceccarelli G, Mastroianni CM, d'Ettorre G. Immune Reconstitution and Safe Metabolic Profile after the Switch to Bictegravir/Emtricitabine/Tenofovir Alafenamide Fumarate among Virologically Controlled PLWH: A 96 Week Update from the BICTEL Cohort. Viruses. 2023 May 23;15(6):1222. doi:10.3390/v15061222.
17.Jemal M. A review of dolutegravir-associated weight gain and secondary metabolic comorbidities. SAGE Open Med. 2024 Jun 13;12:20503121241260613. doi:10.1177/20503121241260613.