Among people with HIV, metabolic syndrome is more prevalent among those exposed to highly active antiretroviral therapy compared with those who are naïve to the therapy, according to a presentation here.

“Advanced age and increased BMI are independent determinants of [metabolic syndrome] in [highly active antiretroviral therapy]-treated patients,”Fakhraddeen Muhammad, MBBS, FWACP, of Aminu Kano Teaching Hospital in Kano, Nigeria, and colleagues wrote. “Lifestyle measures and regular monitoring or anthropometric indices of HIV patients will help to reduce the metabolic problems associated with drug treatment.”

Muhammad and colleagues evaluated 300 adults with HIV attending the HIV clinic at Aminu Kano Teaching Hospital to determine and compare the prevalence and associated factors of metabolic syndrome among highly active antiretroviral therapy (HAART)-exposed compared with HAART-naïve patients. Participants were divided into two age- and sex-matched groups: HAART exposed (mean age, 35.7 years) and HAART naïve (mean age, 34 years). Adult Treatment Panel III criteria were used to diagnose metabolic syndrome, and insulin resistance among participants diagnosed with metabolic syndrome was estimated by homeostasis model of assessment for insulin resistance (HOMA-IR). Sixty-four percent of participants were women.

Compared with 5% of HAART-naïve participants, the prevalence of metabolic syndrome was higher among HAART-exposed participants (19.3%; P < .001). When divided by sex, HAART-exposed participants were still more likely to have metabolic syndrome compared with HAART-naïve participants (men, 8.7% vs. 1.3%; women, 10.7% vs. 4%).

Metabolic syndrome was significantly linked with advanced age (> 40 years), longer duration of HIV diagnosis (> 4 years) and HAART exposure, increased BMI, weight gain after HAART exposure, exposure to protease inhibitors, and increased mean CD4 cell count (P < .05). Age (OR = 1.1; 95% CI, 1.034-1) and BMI (OR = 2.64; 95% CI, 1.403-4.972) were the only factors found to be independently associated with the development of metabolic syndrome.

Insulin resistance was greater among participants who were HAART exposed (79.3%) compared with those who were HAART naïve (25%; P = .008).

“We found that although HAART exposure improves the life expectancy of these patients, they are at increased risk for metabolic syndrome and its risk factors,” Muhammad said. “This is not different from what has been found in other countries.” – by Amber Cox