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AIDS Patient Care STDS. 2018 Jun;32(6):215-222. doi: 10.1089/apc.2018.0052.

Metabolic Syndrome Among Antiretroviral Therapy-Naive Versus Experienced HIV-Infected Patients Without Preexisting Cardiometabolic Disorders in Western Kenya.

Author information

1
1 Department of Obstetrics and Gynecology, University of Nairobi , Nairobi, Kenya .
2
2 Department of Global Health, University of Washington , Seattle, Washington.
3
3 Department of Epidemiology, University of Washington , Seattle, Washington.
4
4 Division of Medicine, Moi Teaching and Referral Hospital , Eldoret, Kenya .
5
5 AMPATH Partnership , Eldoret, Kenya .
6
6 Department of Medicine, School of Medicine, College of Health Sciences, Moi University , Eldoret, Kenya .
7
7 Department of Medicine, University of Washington , Seattle, Washington.
8
8 Department of Medicine, Duke Clinical Research Institute and Duke Global Health Institute, Duke University , Durham, North Carolina.

Abstract

Metabolic syndrome (MetS), a cluster of cardiovascular disease risk factors, is increasingly common in people living with HIV; however, data on prevalence and the role of antiretroviral therapy (ART) as a risk factor for MetS in sub-Saharan Africa are lacking. We conducted a cross-sectional study to assess the prevalence and risk factors for MetS among ART-naive and ART-experienced HIV-infected adults without preexisting cardiometabolic disorders in Western Kenya using validated questionnaires and laboratory tests after overnight fasting. We used logistic regression to identify associations between traditional risk factors, HIV disease characteristics, ART, and MetS. Study participants included 164 ART-experienced patients, majority (56%) on tenofovir/lamivudine/nevirapine regimen, and 136 ART-naive patients. The median age was 40 (interquartile range, 33-46) years and 64% were women. Median HIV infection and ART use were 4.6 (1.7-7.9) and 4.8 (2.7-7.8) years, respectively. Prevalence of MetS did not differ between ART-experienced (16.9%) and -naive (15.2%) groups. ART-experienced patients had higher rates of elevated fasting blood sugars and lower rates of low high-density lipoprotein-cholesterol. The prevalence of abnormal waist circumference, elevated blood pressure, and hypertriglyceridemia were comparable between the two groups. Older age, female sex, and high body mass index were independently associated with diagnosis of MetS. Traditional risk factors rather than ART-related effects were more important predictors of MetS in this cohort and may have been influenced by ART type and exclusion of preexisting hypertension and diabetes. HIV-infected patients without preexisting cardiometabolic disorders should be monitored for metabolic abnormalities regardless of ART.

KEYWORDS:

HIV; Kenya; antiretroviral therapy; cardiovascular diseases; metabolic syndrome; sub-Saharan Africa

PMID:
29851503
PMCID:
PMC5982154
[Available on 2019-06-01]
DOI:
10.1089/apc.2018.0052

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