Analysis of the metabolic syndrome and its association with cART in HIV positive individuals receiving various cART regimens with review of literature

Abstract

Context: Many endocrine and metabolic disorders are seen in patients with HIV infection. Various comorbidities have been reported at a higher rate in HIV positive individuals, some at an earlier age. Since metabolic syndrome and its determinants are slowly developing, studies are needed in this regard. Aims: The study aimed to analyze various parameters associated with the metabolic syndrome in HIV positive individuals and stratify subjects based on their treatment regimens, and present a brief comparison based on the same. Settings and Design: A cross sectional study involving 155 participants was conducted at a tertiary care centre in Western India. Materials and Methods: Detailed history and clinical examination was carried out. Routine investigations were done and parameters of interest to the study were then analysed based on AHA/NHLBI definitions. Statistical Analysis used: Univariate analysis of all parameters. Multiple logistic regression for statistically significant parameters. Results and Conclusion: Deranged HDL cholesterol was the most common component of the metabolic syndrome seen amongst all participants (53.8%) which was significantly higher in the treatment naive group (P = 0.001). The difference between the incidence of metabolic syndrome between the ART naive group and patients receiving ART was not significant. Males had a significantly higher prevalence of metabolic syndrome than females (26.3%>12.4%, P = 0.026). There was a significant difference in the incidence between the Zidovudine and Tenofovir treatment groups(P=0.02). Patients on the TLE (Tenofovir, Lamivudine, and Efavirenz) regimen had the lowest prevalence (4.2%) of metabolic syndrome. Keywords: HIV, Metabolic Syndrome, cART, HAART, Tenofovir, Zidovudine