Association of Helicobacter pylori infection with the metabolic syndrome among HIV-infected black Africans receiving highly active antiretroviral therapy.
BACKGROUND
The metabolic syndrome (MetS) is common in human immune deficiency virus (HIV)-infected individuals receiving highly active antiretroviral therapy (HAART). Immune deficiencies caused by HIV give rise to numerous opportunistic gastrointestinal pathogens such as Helicobacter pylori, the commonest cause of chronic gastritis. The study sought to determine the relationship between H pylori infection and the MetS among HIV-infected clinic attendees.


METHODS
This cross-sectional study was carried out in a specialised heart clinic in Kinshasa, DR Congo. Between January 2004 and December 2008, 116 HIV-infected patients (61 with MetS and 55 without MetS) who underwent upper gastrointestinal endoscopy for dyspeptic symptoms were included in the study following an informed consent. Univariate associations were determined by odds ratios (OR), while multivariate logistic regression analysis was used to identify factors associated with the MetS.


RESULTS
H pylori infection (OR = 13.5, 95% CI: 10.3-17.6; p < 0.0001) and peripheral obesity (median hip circumference ≥ 97 cm) (OR = 4.7, 95% CI: 1.2-18.8; p = 0.029) were identified as MetS-related factors in HIV-infected patients. Higher rates of the MetS were associated with increased incidence of HIV-related immunocompromise using World Health Organisation (WHO) staging criteria. There was a univariate significant difference in the prevalence of the MetS between antiretroviral therapy (ART)-naïve patients and patients treated by means of a first-line HAART regimen of stavudine (d4T), lamivudine (3TC) and nevirapine (NVP). However, this difference was not significant in multivariate logistic analysis.


CONCLUSIONS
H pylori infection was significantly associated with the MetS in HIV-infected patients.
Research Unit, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa.
Benjamin
B
Longo-Mbenza
Department of Medical Microbiology, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa. tapalata@wsu.ac.za.
Teke
T
Apalata
Department of Internal Medicine, University of Kinshasa, Democratic Republic of the Congo.
Murielle
M
Longokolo
Department of Internal Medicine, University of Kinshasa, Democratic Republic of the Congo.
Marcel Mbula
MM
Mambimbi
Laboratoire de Biochimie et Pharmacologie, Faculté des Sciences de Santé, Brazzaville, Congo.
Etienne
E
Mokondjimobe
Centre Hospitalier Universitaire, Faculté des Sciences de Santé, University of Marien Ngouabi, Brazzaville, Congo.
Thierry
T
Gombet
Centre Hospitalier Universitaire, Faculté des Sciences de Santé, University of Marien Ngouabi, Brazzaville, Congo.
Bertrain
B
Ellenga
Laboratoire de Biochimie et Pharmacologie, Faculté des Sciences de Santé, Brazzaville, Congo.
Baudouin
B
Buassa-bu-Tsumbu
Biostatistic Unit, Lomo Medical Cardiovascular Centre for Africa, Limete, Kinshasa, Democratic Republic of the Congo.
Guy Milongo
GM
Dipa
Biostatistic Unit, Lomo Medical Cardiovascular Centre for Africa, Limete, Kinshasa, Democratic Republic of the Congo.
Evelyne Lukoki
EL
Luila
Biostatistic Unit, Lomo Medical Cardiovascular Centre for Africa, Limete, Kinshasa, Democratic Republic of the Congo.
Augustin
A
Nge Okwe
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D044383:Black People; D003430:Cross-Sectional Studies; D015023:Democratic Republic of the Congo; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D016481:Helicobacter Infections / Q000453:epidemiology*; D016480:Helicobacter pylori; D006801:Humans; D019259:Lamivudine / Q000008:administration & dosage; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D019829:Nevirapine / Q000008:administration & dosage; D015995:Prevalence; D018119:Stavudine / Q000008:administration & dosage
D019259:Lamivudine; D019829:Nevirapine; D018119:Stavudine