An observational study of the prevalence of metabolic syndrome in treatment-experienced people living with HIV in Singapore.

<h4>Background</h4>While the use of combination antiretroviral therapy (cART) has conferred significant reduction in morbidity and mortality, there are growing concerns about the metabolic complications of antiretroviral regimens in HIV-infected patients. The aim of this study was to est...

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Autores principales:	Li Wei Ang, Oon Tek Ng, Irving Charles Boudville, Yee Sin Leo, Chen Seong Wong
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f6725377422749b480ce73d88e08c3f0
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spelling	oai:doaj.org-article:f6725377422749b480ce73d88e08c3f02021-12-02T20:05:21ZAn observational study of the prevalence of metabolic syndrome in treatment-experienced people living with HIV in Singapore.1932-620310.1371/journal.pone.0252320https://doaj.org/article/f6725377422749b480ce73d88e08c3f02021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252320https://doaj.org/toc/1932-6203<h4>Background</h4>While the use of combination antiretroviral therapy (cART) has conferred significant reduction in morbidity and mortality, there are growing concerns about the metabolic complications of antiretroviral regimens in HIV-infected patients. The aim of this study was to estimate the prevalence of metabolic syndrome (MetS) among people living with HIV (PLHIV) in Singapore.<h4>Methods</h4>We conducted a retrospective study using the clinical database maintained by the Clinical HIV Programme at the National Centre for Infectious Diseases, Singapore. Treatment-experienced PLHIV on follow-up during 2015-2017 were included. MetS was defined as having three or more of the following five abnormalities: hypertriglyceridemia, HDL hypocholesterolemia, hypertension, obesity, and diabetes.<h4>Results</h4>A total of 2,231 PLHIV were included in this study. 93.9% were men, and the median age at latest follow-up was 48 years. The median duration of HIV infection and duration of exposure to cART was 6.8 years and 5.7 years, respectively. All had been exposed to nucleoside reverse transcriptase inhibitors (NRTIs) as the first line of treatment, 93.9% to non-NRTIs, 28.6% to protease inhibitors (PIs) and 12.8% to integrase strand transfer inhibitors. The most common metabolic abnormality among PLHIV was HDL hypocholesterolemia (60.2%) followed by hypertriglyceridemia (45.5%). Of all the 2,231 individuals, 68.8% had at least one component of MetS. The overall prevalence of MetS was 23.6% (95% confidence interval 21.9%-25.4%). Of the 526 with MetS, the most common combination was HDL hypocholesterolemia, hypertriglyceridemia and hypertension (51.0%), followed by HDL hypocholesterolemia, hypertriglyceridemia, hypertension and diabetes (25.1%). Compared with PLHIV without MetS, a significantly higher proportion of those with MetS were ever on protease inhibitors (33.5% vs. 27.1%).<h4>Conclusion</h4>MetS is common in PLHIV. In view of the progressive aging of HIV-infected population and long-term use of cART, regular monitoring for metabolic abnormalities, surveillance of drug effects and behavioural interventions are needed to optimize management and prevention of metabolic disorders in PLHIV.Li Wei AngOon Tek NgIrving Charles BoudvilleYee Sin LeoChen Seong WongPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0252320 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Li Wei Ang Oon Tek Ng Irving Charles Boudville Yee Sin Leo Chen Seong Wong An observational study of the prevalence of metabolic syndrome in treatment-experienced people living with HIV in Singapore.
description	<h4>Background</h4>While the use of combination antiretroviral therapy (cART) has conferred significant reduction in morbidity and mortality, there are growing concerns about the metabolic complications of antiretroviral regimens in HIV-infected patients. The aim of this study was to estimate the prevalence of metabolic syndrome (MetS) among people living with HIV (PLHIV) in Singapore.<h4>Methods</h4>We conducted a retrospective study using the clinical database maintained by the Clinical HIV Programme at the National Centre for Infectious Diseases, Singapore. Treatment-experienced PLHIV on follow-up during 2015-2017 were included. MetS was defined as having three or more of the following five abnormalities: hypertriglyceridemia, HDL hypocholesterolemia, hypertension, obesity, and diabetes.<h4>Results</h4>A total of 2,231 PLHIV were included in this study. 93.9% were men, and the median age at latest follow-up was 48 years. The median duration of HIV infection and duration of exposure to cART was 6.8 years and 5.7 years, respectively. All had been exposed to nucleoside reverse transcriptase inhibitors (NRTIs) as the first line of treatment, 93.9% to non-NRTIs, 28.6% to protease inhibitors (PIs) and 12.8% to integrase strand transfer inhibitors. The most common metabolic abnormality among PLHIV was HDL hypocholesterolemia (60.2%) followed by hypertriglyceridemia (45.5%). Of all the 2,231 individuals, 68.8% had at least one component of MetS. The overall prevalence of MetS was 23.6% (95% confidence interval 21.9%-25.4%). Of the 526 with MetS, the most common combination was HDL hypocholesterolemia, hypertriglyceridemia and hypertension (51.0%), followed by HDL hypocholesterolemia, hypertriglyceridemia, hypertension and diabetes (25.1%). Compared with PLHIV without MetS, a significantly higher proportion of those with MetS were ever on protease inhibitors (33.5% vs. 27.1%).<h4>Conclusion</h4>MetS is common in PLHIV. In view of the progressive aging of HIV-infected population and long-term use of cART, regular monitoring for metabolic abnormalities, surveillance of drug effects and behavioural interventions are needed to optimize management and prevention of metabolic disorders in PLHIV.
format	article
author	Li Wei Ang Oon Tek Ng Irving Charles Boudville Yee Sin Leo Chen Seong Wong
author_facet	Li Wei Ang Oon Tek Ng Irving Charles Boudville Yee Sin Leo Chen Seong Wong
author_sort	Li Wei Ang
title	An observational study of the prevalence of metabolic syndrome in treatment-experienced people living with HIV in Singapore.
title_short	An observational study of the prevalence of metabolic syndrome in treatment-experienced people living with HIV in Singapore.
title_full	An observational study of the prevalence of metabolic syndrome in treatment-experienced people living with HIV in Singapore.
title_fullStr	An observational study of the prevalence of metabolic syndrome in treatment-experienced people living with HIV in Singapore.
title_full_unstemmed	An observational study of the prevalence of metabolic syndrome in treatment-experienced people living with HIV in Singapore.
title_sort	observational study of the prevalence of metabolic syndrome in treatment-experienced people living with hiv in singapore.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/f6725377422749b480ce73d88e08c3f0
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An observational study of the prevalence of metabolic syndrome in treatment-experienced people living with HIV in Singapore.

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