Changes in metabolic syndrome Status after initiation of antiretroviral therapy

Supriya Krishnan, Jeffrey T. Schouten, Benjamin Atkinson, Todd T. Brown, David A. Wohl, Grace A. McComsey, Marshall J. Glesby, Cecilia Shikuma, Richard Haubrich, Denise L. Jacobson

Research output: Contribution to journalArticle

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..

Original languageEnglish (US)
Pages (from-to)73-80
Number of pages8
JournalJournal of acquired immune deficiency syndromes
Volume68
Issue number1
DOIs
StatePublished - Jan 1 2015

Keywords

  • ART
  • Body mass index
  • Changes
  • HIV
  • Metabolic syndrome
  • Prevalence

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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    Krishnan, S., Schouten, J. T., Atkinson, B., Brown, T. T., Wohl, D. A., McComsey, G. A., Glesby, M. J., Shikuma, C., Haubrich, R., & Jacobson, D. L. (2015). Changes in metabolic syndrome Status after initiation of antiretroviral therapy. Journal of acquired immune deficiency syndromes, 68(1), 73-80. https://doi.org/10.1097/QAI.0000000000000397