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Metabolic syndrome among treatment-naïve people living with and without HIV in Zambia and Zimbabwe: a cross-sectional analysis.
Chihota, Belinda V; Mandiriri, Ardele; Shamu, Tinei; Muula, Guy; Nyamutowa, Hellen; Taderera, Charlotte; Mwamba, Daniel; Chilengi, Roma; Bolton-Moore, Carolyn; Bosomprah, Samuel; Egger, Matthias; Chimbetete, Cleophas; Wandeler, Gilles.
Afiliación
  • Chihota BV; Centre for Infectious Disease Research, Lusaka, Zambia.
  • Mandiriri A; Graduate School of Health Sciences, University of Bern, Bern, Switzerland.
  • Shamu T; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
  • Muula G; Newlands Clinic, Harare, Zimbabwe.
  • Nyamutowa H; Graduate School of Health Sciences, University of Bern, Bern, Switzerland.
  • Taderera C; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
  • Mwamba D; Newlands Clinic, Harare, Zimbabwe.
  • Chilengi R; Centre for Infectious Disease Research, Lusaka, Zambia.
  • Bolton-Moore C; Newlands Clinic, Harare, Zimbabwe.
  • Bosomprah S; Newlands Clinic, Harare, Zimbabwe.
  • Egger M; Centre for Infectious Disease Research, Lusaka, Zambia.
  • Chimbetete C; Centre for Infectious Disease Research, Lusaka, Zambia.
  • Wandeler G; Centre for Infectious Disease Research, Lusaka, Zambia.
J Int AIDS Soc ; 25(12): e26047, 2022 12.
Article en En | MEDLINE | ID: mdl-36522287
ABSTRACT

INTRODUCTION:

Chronic viral replication has been linked to an increased risk of cardiovascular and metabolic diseases in people living with HIV (PLWH), but few studies have evaluated this association in Southern Africa. We explored the determinants of metabolic syndrome (MetS) among treatment-naïve adults living with and without HIV in Southern Africa.

METHODS:

Treatment-naïve PLWH and people living without HIV (PLWOH) ≥30 years were consecutively enrolled from primary care clinics in Zambia and Zimbabwe. PLWOH were seronegative partners or persons presenting for HIV testing. We defined MetS as the presence of central obesity plus any two of the following raised blood pressure, impaired fasting glucose, reduced high-density lipoprotein cholesterol and raised triglycerides, as defined by the International Diabetes Federation. We used logistic regression to determine factors associated with MetS.

RESULTS:

Between August 2019 and March 2022, we screened 1285 adults and enrolled 420 (47%) PLWH and 481 (53%) PLWOH. The median age was similar between PLWH and PLWOH (40 vs. 38 years, p < 0.24). In PLWH, the median CD4+ count was 228 cells/mm3 (IQR 108-412) and the viral load was 24,114 copies/ml (IQR 277-214,271). Central obesity was present in 365/523 (70%) females and 57/378 males (15%). MetS was diagnosed in 172/901 (19%, 95% confidence interval [CI] 17-22%), and prevalence was higher among females than males (27% vs. 9%). In multivariable analyses, HIV status was not associated with MetS (adjusted odds ratio [aOR] 1.05, 95% CI 0.74-1.51). Risk factors for MetS included age older than 50 years (aOR 2.31, 95% CI 1.49-3.59), female sex (aOR 3.47, 95% CI 2.15-5.60), highest income (aOR 2.19, 95% CI 1.39-3.44) and less than World Health Organization recommended weekly physical activity (aOR 3.35, 95% CI 1.41-7.96).

CONCLUSIONS:

We report a high prevalence of MetS and central obesity among females in urban Zambia and Zimbabwe. Lifestyle factors and older age appear to be the strongest predictors of MetS in our population, with no evident difference in MetS prevalence between treatment-naïve PLWH and PLWOH.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Infecciones por VIH / Síndrome Metabólico Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: Africa Idioma: En Revista: J Int AIDS Soc Asunto de la revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Año: 2022 Tipo del documento: Article País de afiliación: Zambia

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Infecciones por VIH / Síndrome Metabólico Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: Africa Idioma: En Revista: J Int AIDS Soc Asunto de la revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Año: 2022 Tipo del documento: Article País de afiliación: Zambia