Changes in metabolic syndrome status after initiation of antiretroviral therapy.

TitleChanges in metabolic syndrome status after initiation of antiretroviral therapy.
Publication TypeJournal Article
Year of Publication2015
AuthorsKrishnan S, Schouten JT, Atkinson B, Brown TT, Wohl DA, McComsey GA, Glesby MJ, Shikuma C, Haubrich R, Jacobson DL
JournalJ Acquir Immune Defic Syndr
Volume68
Issue1
Pagination73-80
Date Published2015 Jan 1
ISSN1944-7884
KeywordsAdult, Anti-HIV Agents, Female, HIV Infections, Humans, Male, Metabolic Syndrome X
Abstract

BACKGROUND: Data on changes in metabolic syndrome (MetS) status in HIV-infected adults on antiretroviral therapy (ART) are limited.

METHODS: MetS was assessed at ART initiation and every 48 weeks on ART in ART-naive HIV-infected individuals from the AIDS Clinical Trials Group Longitudinal Linked Randomized Trials (ALLRT) cohort. MetS, defined using the Adult Treatment Panel III criteria, required at least 3 of the following: elevated fasting glucose, hypertension, elevated waist circumference, elevated triglycerides, low high-density lipoprotein (HDL) cholesterol. Prevalence of MetS and the individual criteria were compared between ART initiation and during follow-up using McNemar test.

RESULTS: At ART initiation, 450 (20%) ALLRT participants had MetS. After 96 weeks of ART, 37% of the 411 with MetS at ART initiation and with available data at this time point did not meet the MetS criteria. Among these participants, there was a dramatic decline in the proportion with low HDL (95% versus 26%, P < 0.0001). Among the 63% who continued to meet MetS criteria at week 96, the proportion with ≥4 criteria was higher at week 96 compared to at the time of ART initiation (48% versus 40%, P = 0.03); at week 96, the proportion with high triglycerides was greater (87% versus 69%, P < 0.0001) as was the proportion with high glucose (59% versus 42%, P < 0.0001).

CONCLUSIONS: One in 5 ART-naive subjects met criteria for MetS at ART initiation. Although more than half of these individuals continued to have MetS after 96 weeks of ART, 37% with MetS at ART initiation no longer met criteria for MetS; this decrease was driven largely by increases in HDL cholesterol.

DOI10.1097/QAI.0000000000000397
Alternate JournalJ. Acquir. Immune Defic. Syndr.
PubMed ID25321179
PubMed Central IDPMC4262682
Grant ListAI 38855 / AI / NIAID NIH HHS / United States
AI 38858 / AI / NIAID NIH HHS / United States
AI 68634 / AI / NIAID NIH HHS / United States
AI 68636 / AI / NIAID NIH HHS / United States
AI064086 / AI / NIAID NIH HHS / United States
AI27670 / AI / NIAID NIH HHS / United States
AI36214 / AI / NIAID NIH HHS / United States
HL095135 / HL / NHLBI NIH HHS / United States
K24 AI064086 / AI / NIAID NIH HHS / United States
K24 AI078884 / AI / NIAID NIH HHS / United States
K24 AI078884 / AI / NIAID NIH HHS / United States
P30 AI036214 / AI / NIAID NIH HHS / United States
P30 AI050410 / AI / NIAID NIH HHS / United States
R01 HL095135 / HL / NHLBI NIH HHS / United States
U01 AI027670 / AI / NIAID NIH HHS / United States
U01 AI038855 / AI / NIAID NIH HHS / United States
U01 AI038858 / AI / NIAID NIH HHS / United States
U01 AI068634 / AI / NIAID NIH HHS / United States
U01 AI068636 / AI / NIAID NIH HHS / United States
U01 AI069419 / AI / NIAID NIH HHS / United States
U01 AI69419 / AI / NIAID NIH HHS / United States
UM1 AI068634 / AI / NIAID NIH HHS / United States
UM1 AI068636 / AI / NIAID NIH HHS / United States
UM1 AI069419 / AI / NIAID NIH HHS / United States
UM1 AI069423 / AI / NIAID NIH HHS / United States
UM1 AI069432 / AI / NIAID NIH HHS / United States