Metabolic syndrome in patients on first-line antiretroviral therapy containing zidovudine or tenofovir in rural Lesotho, Southern Africa.
To assess the prevalence of metabolic syndrome (MetS) among patients in rural Lesotho who are taking first-line antiretroviral therapy (ART) containing either zidovudine or tenofovir disoproxil.



Cross-sectional survey in 10 facilities in Lesotho among adult (≥16 years) patients on non-nucleoside reverse transcriptase inhibitor (NNRTI)-based first-line ART for ≥6 months. MetS was defined according to the International Diabetes Federation criteria.



Among 1166 patients (65.8% female), 22.2% (95% CI: 19.3-25.3) of women and 6.3% (4.1-9.1) of men met the IDF definition of MetS (P < 0.001). In both sexes, there was no significant difference in MetS prevalence between NNRTIs. However, in women taking zidovudine as nucleoside reverse transcriptase inhibitor (NRTI), MetS prevalence was 27.9%, vs. 18.8% in those taking tenofovir. In the multivariate logistic regression allowing for socio-demographic and clinical covariates, ART containing zidovudine was associated with MetS in women (aOR 2.17 (1.46-3.22), P < 0.001) but not in men.



In this study, taking ART containing zidovudine instead of tenofovir disoproxil was an independent predictor of MetS in women but not in men. This finding endorses WHO's recommendation of tenofovir as preferred NRTI.
Swiss Tropical and Public Health Institute, Basel, Switzerland.|University of Basel, Basel, Switzerland.
Niklaus Daniel
ND
Labhardt
Swiss Tropical and Public Health Institute, Basel, Switzerland.|University of Basel, Basel, Switzerland.
Urs Franz
UF
Müller
SolidarMed, Swiss Organization for Health in Africa, Maseru West, South Africa.
Isaac
I
Ringera
SolidarMed, Swiss Organization for Health in Africa, Luzern, Switzerland.
Jochen
J
Ehmer
SolidarMed, Swiss Organization for Health in Africa, Maseru West, South Africa.
Mokete M
MM
Motlatsi
SolidarMed, Swiss Organization for Health in Africa, Luzern, Switzerland.
Karolin
K
Pfeiffer
SolidarMed, Swiss Organization for Health in Africa, Luzern, Switzerland.
Michael A
MA
Hobbins
SolidarMed, Swiss Organization for Health in Africa, Maseru West, South Africa.
Josephine A
JA
Muhairwe
Central Laboratories, Cantonal Hospital Basel-Land, Liestal, Switzerland.
Juergen
J
Muser
Swiss Tropical and Public Health Institute, Basel, Switzerland.|University of Basel, Basel, Switzerland.
Christoph
C
Hatz
D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans; D007927:Lesotho; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D015995:Prevalence; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D012424:Rural Population; D012737:Sex Factors; D000068698:Tenofovir / Q000627:therapeutic use*; D015215:Zidovudine / Q000009:adverse effects* / Q000627:therapeutic use
D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors; D015215:Zidovudine; D000068698:Tenofovir

VIH
; Africa; Afrique; HIV; Lesotho; Lesoto; Tenofovir; Zidovudina; antiretroviral therapy; metabolic syndrome; syndrome métabolique; síndrome metabólico; tenofovir; terapia antirretroviral; thérapie antirétrovirale; ténofovir; zidovudine; África