The metabolic syndrome, an epidemic among HIV-infected patients on HAART - 02/06/09
, G. Dragović b, D. Salemović a, J. Ranin a, O. Djurković-Djaković c, ⁎ 
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Summary |
Background |
HAART has dramatically changed the prognosis of AIDS, but has led to long-term toxicities of antiretroviral drugs. A major chronic complication is the metabolic syndrome (MS), including hyperlipidemia, lipodystrophy (LD), and impaired glucose metabolism.
Methods |
A cross-sectional study of a series of 582 patients from the Serbian HIV/AIDS cohort, treated with HAART for a mean period of 3.3±2.1 years (range 1–10), was performed to evaluate the prevalence and risk factors for MS during HAART.
Results |
The prevalence of LD was 29.1%, with a 100% probability of development after 10 years of treatment. Risk factors for LD included female gender (OR 1.7, 95% CI 1.0–2.7, P=0.02), age>40 (OR 1.7, 95% CI 1.1–2.7, P=0.01) and AIDS at HAART initiation (OR 1.9, 95% CI 1.2–2.2, P<0.01), as well as prolonged usage of NRTIs (OR 2.7, 95% CI 1.6–4.5, P<0.01). The NNRTI-based regimens were less likely to induce LD than those PI-based (OR 1.87, 95% CI 1.2–2.9 vs. OR 3.7, 95% CI 2.3–6.1, respectively). Hyperlipidemia occurred in 47% of the patients, and was associated with male gender (OR 2.2, 95% CI 1.4–3.5, P<0.01) and prolonged usage of PI+NNRTI HAART (OR 3.0, 95% CI 1.8–4.9, P<0.01). In contrast, regimens composed of 2 NRTI+NNRTI were less likely to induce hyperlipidemia (OR 0.4, 95% CI 0.3–0.7, P=0.03). Glucose intolerance and/or diabetes mellitus was recorded in 9.6%, if with AIDS at HAART initiation (OR 3.7, 95% CI 1.2–11.4, P<0.01), male gender (OR 5.2, 95% CI 1.8–15.1, P<0.01) and age>40 (OR 2.6, 95% CI 1.1–6.3, P=0.02).
Conclusion |
MS seems an inevitable consequence of long-term successful HAART.
Le texte complet de cet article est disponible en PDF.Keywords : HIV, HAART, Metabolic syndrome (MS)
Plan
Vol 63 - N° 5
P. 337-342 - juin 2009 Retour au numéro
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