Abstract:
Metabolic syndrome (MetS), a cluster of cardiovascular disease risk factors, is increasingly common in people
living with HIV; however, data on prevalence and the role of antiretroviral therapy (ART) as a risk factor for
MetS in sub-Saharan Africa are lacking. We conducted a cross-sectional study to assess the prevalence and risk
factors for MetS among ART-naive and ART-experienced HIV-infected adults without preexisting cardio-
metabolic disorders in Western Kenya using validated questionnaires and laboratory tests after overnight
fasting. We used logistic regression to identify associations between traditional risk factors, HIV disease
characteristics, ART, and MetS. Study participants included 164 ART-experienced patients, majority (56%) on
tenofovir/lamivudine/nevirapine regimen, and 136 ART-naive patients. The median age was 40 (interquartile
range, 33–46) years and 64% were women. Median HIV infection and ART use were 4.6 (1.7–7.9) and 4.8 (2.7–
7.8) years, respectively. Prevalence of MetS did not differ between ART-experienced (16.9%) and -naive
(15.2%) groups. ART-experienced patients had higher rates of elevated fasting blood sugars and lower rates of
low high-density lipoprotein-cholesterol. The prevalence of abnormal waist circumference, elevated blood
pressure, and hypertriglyceridemia were comparable between the two groups. Older age, female sex, and high
body mass index were independently associated with diagnosis of MetS. Traditional risk factors rather than
ART-related effects were more important predictors of MetS in this cohort and may have been influenced by
ART type and exclusion of preexisting hypertension and diabetes. HIV-infected patients without preexisting
cardiometabolic disorders should be monitored for metabolic abnormalities regardless of ART.
