Is Metabolic Syndrome Associated to HIV Infection Per Se? Results from the HERMES Study

Abstract

HERMES is a prospective study, including all treatment-naïve patients attending scheduled visits at hospitals in the CISAI group in 2007. The present cross-sectional analysis aims to assess the baseline prevalence and characteristics of Metabolic Syndrome (MS) in a population of HIV-positive treatment-naïve patients. MS was diagnosed using the National Cholesterol Education Program (NCEP) definitions. A total of 292 subjects were enrolled, median age was 37 years, 75% of them were males. The prevalence of MS was 12.3%. The most frequent trio of abnormalities that led to the diagnosis of MS was high blood pressure, triglycerides and HDL. Univariate analysis showed that MS was associated with the following variables: age, education, physical activity, advanced HIV disease (CDC stage C or HIV-RNA >100,000 copies + CD4 <100 cells/mm(3)). Higher educational levels remained protectively associated with MS in multivariate analysis. A higher risk of MS was also associated with advanced HIV disease. Actually, treatment-naïve HIV-positive patients in an advanced stage of the disease have a higher prevalence of abnormal levels of triglycerides, HDL cholesterol and blood glucose than those at a less advanced stage. These findings of the HERMES study suggest, therefore, that HIV infection per se is associated to MS.

Metabolic Syndrome Predicts All-Cause Mortality in Persons with Human Immunodeficiency Virus

“…5 Similarly, other studies have shown a higher prevalence of metabolic syndrome among HIV-infected individuals with detectable viremia and an increased risk of metabolic syndrome in those with advanced HIV disease (CDC class C, VL > 100,000 or CD4 < 100). 22,31 Therefore, an increased risk of all-cause mortality from metabolic syndrome seen in our cohort may be a reflection of the inter-relationship of systemic inflammation, metabolic abnormalities, and HIV disease.…”

The feature of Metabolic Syndrome in HIV naive patients is not the same of those treated: Results from a prospective study

“…Smoking and alcohol consumption were recorded (detailed description were previously reported [9]) at study entry and end. Information on co-infection with Hepatitis B or C viruses were collected, as well as diagnosis of chronic hepatitis and its cause.…”

“…Recently, we have published the results of the cross-sectional analysis of 292 HAART-naive subjects enrolled in 2007 [9]. Among them, the prevalence of MS was 12.3%, increasing with age and lower education.…”

HIV-1 Infection and the Aging of the Immune System: Facts, Similarities and Perspectives

“…92 Patients infected by HIV appear to have higher prevalence of the metabolic syndrome. 93,94 Drug-induced metabolic changes, that include derangement of lipid and glucose metabolism, along with older age, have been associated with increased risk of cardiovascular disease and myocardial infection. 95 Age-related changes in body composition can also influence drug pharmacokinetics by altering drug volume of distribution.…”