Metabolic Syndrome in HIV/AIDS Patients at the Tiko Central Clinic and Cottage Hospital in Cameroon: Influence on Cardiovascular Risk and Predictors

摘要

Highly active anti-retroviral therapy (HAART) use by HIV patients since the mid-1990's has led to a significant drop in HIV mortality. However, HAART and HIV related metabolic syndrome (hypertriglyceridaemia, reduced HDL-c, abdominal obesity, hypertension, and insulin resistance) is associated with increased cardiovascular risk in aging HIV sero-positive patients. This study was aimed at investigating the predictors of metabolic syndrome and influence of metabolic syndrome on cardiovascular (CV) risk amongst persons living with HIV on HAART. This is a hospital-based case-control study. The cases were HIV sero-positive individuals on HAART for at least 6 months and controls were HIV sero-negative individuals. Out of 135 participants, 74 (54.8%) were females amongst which 53/75 (70.7%) were in the cases group and 21/60 (35%) were in the control group. The mean age of the participants was 42.04 (9.61) years. HIV-infected participants at moderate CV risk based on the DAD risk calculator were more frequently diagnosed with metabolic syndrome based on the International Diabetes Federation (IDF) criteria with high statistical significance than those at low CV risk (5/19 - 26.3% vs. 12/55 - 21.8%, P=0.001). Bivariate analysis of metabolic syndrome predictors in the study population revealed that gender is associated with increased odds of metabolic syndrome (OR: 5.376, 95% CI: 1.907-15.153; P=0.001). Gender was the only predictor associated with metabolic syndrome (OR: 6.958, CI: 2.317-20.896; P=0.001) following multivariate analysis of gender, vegetables or fruits intake, vigorous physical activity and family history of CVD and females were 7 times more likely to develop metabolic syndrome than males. More HAART-treated HIV patients at moderate CVD risk develop metabolic syndrome than those at low CVD risk. Female HIV patients on HAART have higher chances of developing metabolic syndrome compared to their male counterparts. HIV patients particularly females should be screened early for metabolic syndrome following HAART initiation.