The metabolic syndrome, an epidemic among HIV-infected patients on HAART

被引:22
作者
Jevtovic, Dj. [2 ]
Dragovic, G. [3 ]
Salemovic, D. [2 ]
Ranin, J. [2 ]
Djurkovic-Djakovic, O. [1 ]
机构
[1] Univ Belgrade, Dept Med Parasitol, Inst Med Res, Belgrade 11129, Serbia
[2] Univ Belgrade, Sch Med, Clin Ctr Serbia, Inst Infect & Trop Dis, Belgrade 11129, Serbia
[3] Univ Belgrade, Sch Med, Inst Pharmacol Clin Pharmacol & Toxicol, Belgrade 11129, Serbia
关键词
HIV; HAART; Metabolic syndrome (MS); C VIRUS; LIPODYSTROPHY; THERAPY; RISK; STAVUDINE;
D O I
10.1016/j.biopha.2008.09.011
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Background: HAART has dramatically changed the prognosis of AIDS, but has led to long-term toxicities of antiretroviral drugs. A major chronic complication is the metabolic syndrome (MS), including hyperlipidemia, lipodystrophy (LD), and impaired glucose metabolism. Methods: A cross-sectional study of a series of 582 patients from the Serbian HIV/AIDS cohort, treated with HAART for a mean period of 3.3 +/- 2.1 years (range 1-10), was performed to evaluate the prevalence and risk factors for MS during HAART. Results: The prevalence of LID was 29.1%, with a 100% probability of development after 10 years of treatment. Risk factors for LD included female gender(OR 1.7, 95% CI 1.0-2.7, P = 0.02), age > 40 (OR 1.7,95% CI 1.1-2.7, P = 0.01) and AIDS at HAART initiation (OR 1.9,95% CI 1.2-2.2, P < 0.01), as well as prolonged usage of NRTIs (OR 2.7, 95% CI 1.6-4.5, P < 0.01). The NNRTI-based regimens were less likely to induce LD than those PI-based (OR 1.87, 95% CI 1.2-2.9 vs. OR 3.7, 95% CI 2.3-6.1, respectively). Hyperlipidemia occurred in 47% of the patients, and was associated with male gender (OR 2.2, 95% CI 1.4-3.5, P < 0.01) and prolonged usage of PI + NNRTI HAART (OR 3.0, 95% CI 1.8-4.9, P < 0.01). In contrast, regimens composed of 2 NRTI + NNRTI were less likely to induce hyperlipidemia (OR 0.4, 95% CI 0.3-0.7, P = 0.03). Glucose intolerance and/or diabetes mellitus was recorded in 9.6%, if with AIDS at HAART initiation (OR 3.7, 95% CI 1.2-11.4, P < 0.01), male gender (OR 5.2, 95% CI 1.8-15.1, P < 0.01) and age > 40 (OR 2.6, 95% CI 1.1-6.3, P = 0.02). Conclusion: MS seems an inevitable consequence of long-term successful HAART. (C) 2008 Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:337 / 342
页数:6
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