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The metabolic syndrome, an epidemic among HIV-infected patients on HAART

D J Jevtović1, G Dragović, D Salemović

  • 1Institute for Infectious and Tropical Diseases, Clinical Centre of Serbia, Belgrade University School of Medicine, Belgrade, Serbia. djordjejevtovic@hotmail.com

Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie
|November 11, 2008
PubMed

Insights

Metabolic syndrome (MS) is a common complication of highly active antiretroviral therapy (HAART) for HIV/AIDS. Long-term HAART use increases the risk of lipodystrophy, hyperlipidemia, and glucose intolerance, suggesting MS is an inevitable consequence.

Area of Science:

  • Infectious Diseases
  • Endocrinology
  • Pharmacology

Background:

  • Highly active antiretroviral therapy (HAART) has improved HIV/AIDS prognosis but causes long-term drug toxicities.
  • Metabolic syndrome (MS), including hyperlipidemia, lipodystrophy (LD), and impaired glucose metabolism, is a significant chronic complication.

Purpose of the Study:

  • To evaluate the prevalence and risk factors for MS in patients receiving long-term HAART.
  • To identify specific antiretroviral drug classes and patient characteristics associated with MS development.

Main Methods:

  • A cross-sectional study of 582 patients from the Serbian HIV/AIDS cohort was conducted.
  • Patients had a mean HAART duration of 3.3 years (range 1-10).
  • Prevalence and risk factors for LD, hyperlipidemia, and glucose intolerance were analyzed.

Main Results:

  • Lipodystrophy (LD) prevalence was 29.1%, with risk factors including female gender, age >40, AIDS at HAART initiation, and NRTI use. PI-based regimens were more likely to induce LD than NNRTI-based ones.
  • Hyperlipidemia affected 47% of patients, associated with male gender and prolonged PI+NNRTI use. NRTI+NNRTI regimens were less likely to induce hyperlipidemia.
  • Glucose intolerance/diabetes occurred in 9.6%, linked to AIDS at HAART initiation, male gender, and age >40.

Conclusions:

  • Metabolic syndrome (MS) appears to be an unavoidable consequence of successful long-term HAART.
  • Understanding risk factors and drug-specific toxicities is crucial for managing MS in HIV/AIDS patients on HAART.
Abstract

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