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

Abstract

We examined the association between metabolic syndrome (MS) and its individual defining criteria on all-cause mortality in human immunodeficiency virus (HIV)-infected persons. We used data from 567 HIV-infected participants of the Nutrition for Healthy Living study with study visits between 9/1/2000 and 1/31/2004 and determined mortality through 12/31/2006. MS was defined using modified National Cholesterol Education Program guidelines. Cox proportional hazards for all-cause mortality were estimated for baseline MS status and for its individual defining criteria. There were 83 deaths with median follow-up of 63 months. Baseline characteristics associated with increased risk of mortality were: older age in years (univariate hazard ratio [HR] 1.04, p<0.01), current smoking (HR 1.99, p=0.02), current heroin use (HR 1.97, p=0.02), living in poverty (HR 2.0, p<0.01), higher mean HIV viral load (HR 1.81, p<0.01), and having a BMI <18 (HR 5.84, p<0.01). For MS and its criteria, only low HDL was associated with increased risk of mortality on univariate analysis (HR 1.84, p=0.01). However, metabolic syndrome (adjusted HR 2.31, p=0.02) and high triglycerides (adjusted HR 3.97, p<0.01) were significantly associated with mortality beyond 36 months follow-up. MS, low HDL, and high triglycerides are associated with an increased risk of mortality in HIV-infected individuals.

High Prevalence of Signs of Renal Damage Despite Normal Renal Function in a Cohort of HIV-Infected Patients: Evaluation of Associated Factors

“…In fact, aging is related not only with an increased incidence of renal disease but also with an increased incidence of other comorbidities. 16 However, in contrast with findings reported elsewhere, [13][14][15] viral load was not associated with an increase in the risk of kidney disease or proteinuria in our study, probably because of the viral suppression and preserved immune status (a protective factor) recorded in the most of our patients, which reduced the impact of HIV-related factors on renal alterations.…”

“…[13][14][15] As is usual in several co-morbidities, age is a factor at risk to developed or worsened renal disease. 16 Renal disease has several clinical manifestations, from subclinical forms of renal damage, to decreased GFR or renal failure at end stages. 11 On the other hand, the relevance of renal damage in the HIV-infected population can be seen in the independent association between microalbuminuria and AIDS-related death (HR, 2.3; 95%CI, 1.3-4.3).…”

Factors associated with zidovudine substitution in HIV/AIDS patients attending Badung Hospital, Bali, Indonesia between 2006-2014

“…Several studies have reported that AZT substitution is related to the patient's age, sex, clinical stage, hemoglobin levels and HIV transmission route. [4][5][6] However, there is A longitudinal study of AZT substitution has not been conducted in district level ART services in Indonesia. Given the relatively high incidence of AZT substitution and the impact treatment side effects can have on a person's quality of life, this study aimed to use longitudinal data from a public HIV treatment hospital in Indonesia to determine the risk of AZT substitution and the factors associated with it in HIV/AIDS patients starting AZT based ART.…”

Lifestyle Medicine and HIV-Infected Patients

“…MetS increases the risk for development of CVD, T2D, cardiovascular mortality, and all-cause mortality. The Nutrition for Healthy Living (NFHL) study analyzed data from 567 subjects and found that MetS and high triglycerides were associated with an increased risk of death after 36 months of follow-up [4]. It is very important to screen HIVinfected patients for MetS and address all nutrition-related causes.…”