Features of Metabolic Syndrome and Its Associated Factors during Highly Active Antiretroviral Therapy in Ouagadougou (Burkina Faso)

Guira, Oumar; Tiéno, H.; Diendéré, Arnaud Eric; Sagna, Yempabou; Diallo, I; Yaméogo, Bertille; Zoungrana, Lassané; Yaméogo, Tènè Marceline; Bognounou, Réné; Drabo, Joseph

doi:10.1177/2325957415601503

Cited by 29 publications

(30 citation statements)

References 19 publications

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“…Associated factors were PI regimens, female sex, age >42 years ( p =0.001) and lipodystrophy ( p =0.01). 64 …”

Section: Methodsmentioning

confidence: 99%

Diabetes, metabolic syndrome and dyslipidemia in people living with HIV in Africa: re-emerging challenges not to be forgotten

Husain¹,

Noor²,

Elmadhoun³

et al. 2017

HIV

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BackgroundThe current challenge in managing people living with human immunodeficiency virus (PLWHIV) includes the identification and monitoring for comorbid health risks associated with HIV and its treatment and longer survival. Dyslipidemia, diabetes mellitus and metabolic syndrome are increasingly seen in PLWHIV.ObjectiveIn this narrative review, we aimed to summarize the current knowledge about diabetes, dyslipidemia and metabolic syndrome in PLWHIV in Africa and also to discuss the challenges that patients as well as health authorities in Africa may face.MethodsPubMed and Google scholar published-English literatures concerning earlier mentioned entities regardless of time limit were critically reviewed.ResultsThe prevalence of metabolic disorders in HIV population in Africa was estimated to range from 2.1% to 26.5% for diabetes and 20.2% to 43.5% for pre-diabetes, 13% to 58% for metabolic syndrome and 13% to 70% for dyslipidemia.ConclusionThe management of metabolic disorders and cardiovascular disease risks related to HIV is complex especially in Africa due to healthcare resources, but our experience suggests that metabolic clinic is beneficial to patients and staff and should be an important part of HIV services especially as the older HIV population is increasing. In this context, cardiovascular risk assessment of HIV-infected patients will become an important component of care in developing countries in Africa and strategies are needed to deal with progressive increase in the epidemic of type 2 diabetes, dyslipidemia and metabolic syndrome.

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“…Associated factors were PI regimens, female sex, age >42 years ( p =0.001) and lipodystrophy ( p =0.01). 64 …”

Section: Methodsmentioning

confidence: 99%

Diabetes, metabolic syndrome and dyslipidemia in people living with HIV in Africa: re-emerging challenges not to be forgotten

Husain¹,

Noor²,

Elmadhoun³

et al. 2017

HIV

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“…Indeed, hyperglycemia was observed in 18% of patients (including 12% diabetes) versus 4% in untreated subjects (including 2% diabetes), p < 0.0001. Guira O. in Burkina Faso found that 29.6% of subjects had hyperglycemia [7]. Likewise the lipid profile of subjects treated is different from that of untreated: 44% had hypercholesterolemia versus 13%, p = 0.02.…”

Section: Discussionmentioning

confidence: 95%

Influence of Antiretroviral Therapy on the Metabolic Profile of People Living with HIV Followed at University Hospital, Cotonou, Benin

Zannou¹,

Azon-Kouanou²,

Ahomadegbe³

et al. 2015

OJIM

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Introduction: Since the advent of antiretroviral therapy, the vital prognosis of people living with HIV (PLWHA) has improved significantly. However, the risk of metabolic complications is high, thus making the bed of cardiovascular disease. Our objective was to compare the prevalence of metabolic abnormalities among PLWHA receiving ARVs to that observed in those who are not treated. Methods: We conducted a cross-sectional study (January to April 2010) at the PLWHA ambulatory care center of national university hospital (CNHU-Hubert K. Maga) in Cotonou, Bénin. We recruited 420 PLWHA (210 treated for at least 6 months and 210 untreated). We determined the prevalence of metabolic syndrome (MS) defined by the criteria of NCEP-ATP III, and the prevalence of abnormal glucose and lipid, and lipodystrophy. Association between metabolic syndrome and ARVs used was analyzed by binomial regression. Confidence intervals were calculated at 95% and 5% alpha level. Results: The prevalence of MS was 16% (18% of patients treated vs. 13% of non-treated, p = 0.18). That of hyperglycemia was 18% (30% of patients treated vs. 6% of untreated; p < 0.001) and of diabetes 7% (12% of patients treated vs 2% of untreated; p < 0.0001). *Corresponding author. D. M. Zannou et al. 107The total cholesterol prevalence was 29% (44% of treated vs 13% of untreated; p <0.02). That of lipodystrophy in 210 patients was 29% (lipoatrophy16%, lipohypertrophy 8%, mixed form 6%).

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“…Bilirrubin elevation is a known adverse effect of atazanavir during pregnancy or anytime of use. It is known that protease inhibitors can cause lipid metabolic changes, metabolic syndrome, lipodystrophy, changes in the carbohydrate metabolism and increased cardiovascular risk in every HIV infected patient [ 47 – 49 ]. Some studies had demonstrated that during pregnancy women in use of PI also presented higher rates of dyslipidemia, metabolic syndrome, lipodystrophy, diabetes and pre-eclampsia [ 50 – 52 ], as some of our data also demonstrated.…”

Section: Discussionmentioning

confidence: 99%

Adverse effects of antiretroviral therapy in pregnant women infected with HIV in Brazil from 2000 to 2015: a cohort study

et al. 2018

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BackgroundAntiretroviral therapy (ART) use in pregnancy presents unquestionable benefits in preventing mother-to-child transmission (MTCT) of HIV although it is associated with maternal adverse effects. The aim of this study was to evaluate the adverse effects of antiretroviral therapy in pregnant women infected with HIV.MethodsCohort study of pregnant women infected with HIV followed at the CAISM/UNICAMP Obstetric Clinic from 2000 to 2015. The following maternal adverse effects were observed: anemia, thrombocytopenia, allergy, liver function test abnormalities, dyslipidemia and diabetes. Data collected from patients’ files was added to a specific database. Descriptive analysis was shown in terms of absolute (n) and relative (%) frequencies and mean, median and standard deviation calculations. Chi-square or Fisher exact test (n < 5) and relative risk (RR) with its respective p values were used for categorical variables and Student t-test (parametric data) or Mann-Whitney (non-parametric data) for the quantitative ones. A 95% confidence interval (CI) and a significant level of 0.05 were used. A multivariate Cox Logistic Regression was also done. Data analysis was conducted using SAS version 9.4.ResultsData from 793 pregnancies were included. MTCT rate was 2.3%, with 0.8% in the last 5 years. Maternal adverse effects were: dyslipidemia (82%), anemia (56%), liver function test abnormalities (54.5%), including hyperbilirubinemia (11.6%), fasting glycemia alteration (19.2%), thrombocytopenia (14.1%), and allergic reaction (2.7%). The majority of adverse effects deemed related to ART in this study were mild according to DAIDS scale. In the multivariate analysis, co-infections and starting ART during pregnancy were risk factors for maternal anemia, while CD4 count higher than 200 cells/mm3 was protective. Nevirapine, nelfinavir and atazanavir regimens increased the risk for liver function tests abnormalities. Lopinavir use during pregnancy increased the risk for fasting glycemia alteration.ConclusionThe evolution of the national guidelines of antiretroviral therapy for pregnant women improved adherence to the treatment and resulted in a significant reduction of MTCT. Despite the high frequency of maternal adverse effects, they are mostly of low severity. Newer ART medications with improved efficacy and significantly more favorable tolerability profiles should reduce the incidence of ART-related adverse effects.

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Features of Metabolic Syndrome and Its Associated Factors during Highly Active Antiretroviral Therapy in Ouagadougou (Burkina Faso)

Abstract: Cardiovascular risks should be regarded during the care of HIV-infected patients.

Cited by 29 publications

References 19 publications

Diabetes, metabolic syndrome and dyslipidemia in people living with HIV in Africa: re-emerging challenges not to be forgotten

Diabetes, metabolic syndrome and dyslipidemia in people living with HIV in Africa: re-emerging challenges not to be forgotten

Influence of Antiretroviral Therapy on the Metabolic Profile of People Living with HIV Followed at University Hospital, Cotonou, Benin

Adverse effects of antiretroviral therapy in pregnant women infected with HIV in Brazil from 2000 to 2015: a cohort study

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