title: Burden of metabolic syndrome among HIV-infected patients in Southern Ethiopia.
abstract: BACKGROUND
  HIV infection and highly active antiretroviral therapy (HAART) can induce metabolic disturbances including lipodystrophy, dyslipidemia, and insulin resistance, which are reminiscences of metabolic syndrome (MS). However, little is known regarding the magnitude of MS in Ethiopian HIV population. This study, aimed to estimate the prevalence of MS among HIV positive patients with and without HAART.
  
  
  METHODS
  A cross-sectional study was conducted at Hawassa University Referral Hospital, southern Ethiopia between February 2012 and April 2013. Data on demographic and anthropometric characteristics were collected from a total of 374 HIV positive participants (188 on ART and 186 on Pre-ART) using WHO stepwise approach. Fasting blood glucose, total cholesterol, triglyceride, HDL-cholesterol and LDL-cholesterol was measured. The International Diabetes Federation (IDF) and the National Cholesterol Education Program: Adult Treatment Panel III (ATP) Criteria were used to define MS.
  
  
  RESULTS
  Of the 374 study participants 68% were females, and 50.3% were receiving ART. Using the IDF criteria, metabolic syndrome was diagnosed in 25% of patients receiving ART compared to 22.5% of the ART naïve group (OR: 1.14 CI: 0.71-1.84). Using the ATP criteria, the prevalence of MS was 18.1% in the ART groups compared to 15.6% in ART naïve group (OR: 1.20, CI: 0.69-2.06). Patients receiving ART had significantly elevated Cholesterol, triglyceride, glucose and LDL-c levels but lower CD4(+) cell counts than the Pre-ART groups. Being a female, having BMI of at least 25, older age (i.e. age≥45 years) and having total cholesterol of at least 200mg/dl were significantly associated with the presence of MS. Using the ATP criteria to define MS, taking d4T-3TC-EFV regimen was significantly associated with higher odds of MS.
  
  
  CONCLUSIONS
  Almost a quarter of HIV patients on ART developed metabolic syndrome. Furthermore patients on ART had elevated lipid profile and glucose metabolism disturbance than the ART naïve.
authors.affiliation: Hawassa University, College of Medicine and Health Science, Department of Medical Laboratory Sciences, Ethiopia. Electronic address: demoyaf@yahoo.com.
authors.forename: Demo Yemane
authors.initials: DY
authors.lastname: Tesfaye
authors.affiliation: Addis Ababa University, College of Health Sciences, Ethiopia. Electronic address: samuelkinde@yahoo.com.
authors.forename: Samuel
authors.initials: S
authors.lastname: Kinde
authors.affiliation: Addis Ababa University, Aklilu Lemma Institute of Pathobiology, Ethiopia. Electronic address: gtmedhin@yahoo.com.
authors.forename: Girmay
authors.initials: G
authors.lastname: Medhin
authors.affiliation: Addis Ababa University, Department of Biomedical Science, Ethiopia. Electronic address: yoseph.cherinet@aau.edu.et.
authors.forename: Yoseph Cherinet
authors.initials: YC
authors.lastname: Megerssa
authors.affiliation: Hawassa University Referral Hospital, Hawassa University, Ethiopia. Electronic address: agetet@yahoo.com.
authors.forename: Agete
authors.initials: A
authors.lastname: Tadewos
authors.affiliation: Hawassa University, College of Medicine and Health Science, Department of Medical Laboratory Sciences, Ethiopia. Electronic address: endaletd@yahoo.com.
authors.forename: Endale
authors.initials: E
authors.lastname: Tadesse
authors.affiliation: Hawassa University, College of Medicine and Health Science, Department of Medical Laboratory Sciences, Ethiopia. Electronic address: techalew03@yahoo.com.
authors.forename: Techalew
authors.initials: T
authors.lastname: Shimelis
mesh_terms: D000328:Adult; D000886:Anthropometry; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000453:epidemiology; D005002:Ethiopia; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000139:chemically induced / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012737:Sex Factors
chemical_list: D019380:Anti-HIV Agents; D002784:Cholesterol
keywords: ART (anti retroviral treatment); ATP (Adult Treatment Panel III); HIV (human immuno virus); IDF (International Diabetes Federation); Metabolic syndrome