Metabolic syndrome among HIV-infected Taiwanese patients in the era of highly active antiretroviral therapy: prevalence and associated factors.
OBJECTIVE
Metabolic complications related to antiretroviral therapy are rarely investigated among HIV-infected patients in Asian countries. We investigated the prevalence of and factors associated with metabolic syndrome among HIV-infected patients who are ethnic Chinese in the era of highly active antiretroviral therapy (HAART).


METHODS
A cross-sectional survey was performed to collect information on the demographic and clinical characteristics and antiretroviral therapy prescribed in 877 HIV-infected patients at a university hospital in Taiwan from May 2008 to April 2009. The modified Adult Treatment Panel III criteria were used to define metabolic syndrome after adjusting for the waist circumference criteria for Asians.


RESULTS
Of the 877 patients, 75.3% were male homosexuals, 80.7% were receiving HAART and 88.7% had CD4 counts ≥ 200 cells/mm(3). Metabolic syndrome was diagnosed in 210 patients (26.2%). After adjusting for age, gender, smoking status, family history of diabetes mellitus, cardiovascular disease and hypertension, and baseline CD4 and plasma HIV RNA load, use of protease inhibitors (PIs) was significantly associated with the presence of metabolic syndrome (OR 1.63; 95% CI 1.10-2.43). In addition, exposure to PI for ≥ 3 years, to HAART for ≥ 6 years and to nucleoside reverse transcriptase inhibitor(s) for ≥ 6 years was significantly associated with the presence of metabolic syndrome with an adjusted OR of 1.96 (95% CI 1.13-3.42), 1.78 (95% CI 1.03-3.07), and 1.91 (95% CI 1.11-3.30), respectively.


CONCLUSIONS
Approximately one-fourth of HIV-infected Taiwanese patients developed metabolic syndrome in the HAART era. Receipt of HAART and prolonged exposure to PI and nucleoside reverse transcriptase inhibitor(s) were associated with metabolic syndrome.
Department of Internal Medicine,  National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei,  Taiwan.
Pei-Ying
PY
Wu
Chien-Ching
CC
Hung
Wen-Chun
WC
Liu
Chia-Yin
CY
Hsieh
Hsin-Yun
HY
Sun
Ching-Lan
CL
Lu
Hsiu
H
Wu
Kuo-Liong
KL
Chien
D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects* / Q000379:methods; D044466:Asian People; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000139:chemically induced* / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D013624:Taiwan / Q000453:epidemiology
D019380:Anti-HIV Agents