Metabolic syndrome in patients living with HIV/AIDS followed up at a tertiary hospital in Ceará
DOI:
https://doi.org/10.33448/rsd-v14i2.48305Keywords:
Metabolic syndrom; HIV long-term survivors; Infectious disease medicine.Abstract
Introduction: There is a growing number of Patients Living with HIV/AIDS (PLWHA) over 50 years of age, who require good viral control and prevention and management of chronic diseases, such as Metabolic Syndrome (MS). Objective: To evaluate the risk factors for MS in PLWHA. Methods: This is an observational, cross-sectional, retrospective study with a cohort of PLWHA followed in a tertiary hospital. Results: The study involved 195 patients. Of these, 71 had MS and 124 did not. Of the patients with MS, the majority had a high Body Mass Index (BMI): 54.9%, uncontrolled blood pressure: 69%, alterations in HDL: 90% of men, 95.2% of women, Triglycerides: 62% and Glycemia: 85%. The value of Viral Load and CD4 was irrelevant, the majority were undetectable: 83.1% and with CD4>350: 87.1%. Conclusion: In general, high BMI, dyslipidemia and worse glycemic control were the most contributing factors to MS in this sample.
References
Aberg, J. A., Tebas, P., Edgar Turner Overton, Gupta, S. K., Sax, P. E., Landay, A., Falcon, R., Ryan, R. J., & De, G. (2012). Metabolic Effects of Darunavir/Ritonavir Versus Atazanavir/Ritonavir in Treatment-Naive, HIV Type 1-Infected Subjects over 48 Weeks. AIDS Research and Human Retroviruses, 28(10), 1184–1195. https://doi.org/10.1089/aid.2011.0327
Brener, M. I., Post, W. S., Haberlen, S. A., Zhang, L., Palella, F. J., Jacobson, L. P., Dobs, A. S., George, R. T., Witt, M. D., Budoff, M., Kingsley, L. A., & Brown, T. T. (2016). Comparison of Insulin Resistance to Coronary Atherosclerosis in Human Immunodeficiency Virus Infected and Uninfected Men (from the Multicenter AIDS Cohort Study). The American Journal of Cardiology, 117(6), 993–1000. https://doi.org/10.1016/j.amjcard.2015.12.037
Buzón-Martín, L. (2020). Weight gain in HIV-infected individuals using distinct antiretroviral drugs. Aids Reviews, 22(3). https://doi.org/10.24875/aidsrev.m20000036
Cardoso-Neto, É. C., Eduardo Martins Netto, & Brites, C. (2023). Weight gain in patients starting Dolutegravir-based ART according to baseline CD4 count after 48 weeks of follow up. The Brazilian Journal of Infectious Diseases, 27(5), 102807–102807. https://doi.org/10.1016/j.bjid.2023.102807
Caron, M., Auclair, M., Lagathu, C., Lombès, A., Walker, U. A., Kornprobst, M., & Capeau, J. (2004). The HIV-1 nucleoside reverse transcriptase inhibitors stavudine and zidovudine alter adipocyte functions in vitro. AIDS (London, England), 18(16), 2127–2136. https://doi.org/10.1097/00002030-200411050-00004
Costa, C. R. B., Melo, E. S., Antonini, M., Jesus, G. J. de, Pontes, P. S., Gir, E., & Reis, R. K. (2019). Associação entre fatores sociodemográficos e comportamentais com a síndrome metabólica em pessoas vivendo com HIV. Revista Gaúcha de Enfermagem, 40. https://doi.org/10.1590/1983-1447.2019.20180379
Diehl, L. A., Dias, J. R., Paes, A. C. S., Thomazini, M. C., Garcia, L. R., Cinagawa, E., Wiechmann, S. L., & Carrilho, A. J. F. (2008). Prevalência da lipodistrofia associada ao HIV em pacientes ambulatoriais brasileiros: relação com síndrome metabólica e fatores de risco cardiovascular. Arquivos Brasileiros de Endocrinologia & Metabologia, 52(4), 658–667. https://doi.org/10.1590/s0004-27302008000400012
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. (2001). Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA: The Journal of the American Medical Association, 285(19), 2486–2497. https://doi.org/10.1001/jama.285.19.2486
Guaraldi, G., Orlando, G., Zona, S., Menozzi, M., Carli, F., Garlassi, E., ... & Palella, F. (2016). Premature age‐related comorbidities among HIV‐infected persons compared with the general population. Clinical Infectious Diseases, 53(11), 1120-1126.
Henning, R. J., & Greene, J. N. (2023). The epidemiology, mechanisms, diagnosis and treatment of cardiovascular disease in adult patients with HIV. American Journal of Cardiovascular Disease, 13(2), 101. https://pmc.ncbi.nlm.nih.gov/articles/PMC10193251/#sec1
Hsue, P. Y., & Waters, D. D. (2019). HIV infection and coronary heart disease: mechanisms and management. Nature Reviews Cardiology, 16(12), 745–759. https://doi.org/10.1038/s41569-019-0219-9
Koethe, J. R., Jenkins, C. A., Lau, B., Shepherd, B. E., Justice, A. C., Tate, J. P., Buchacz, K., Napravnik, S., Mayor, A. M., Horberg, M. A., Blashill, A. J., Willig, A., Wester, C. W., Silverberg, M. J., Gill, J., Thorne, J. E., Klein, M., Eron, J. J., Kitahata, M. M., & Sterling, T. R. (2016). Rising Obesity Prevalence and Weight Gain Among Adults Starting Antiretroviral Therapy in the United States and Canada. AIDS Research and Human Retroviruses, 32(1), 50–58. https://doi.org/10.1089/aid.2015.0147
Kramer, A. S., Lazzarotto, A. R., Sprinz, E., & Manfroi, W. C. (2009). Alterações metabólicas, terapia antirretroviral e doença cardiovascular em idosos portadores de HIV. Arquivos Brasileiros de Cardiologia, 93(5), 561–568. https://doi.org/10.1590/s0066-782x2009001100019
Loutfy, M. R., Slater, S., Zhang, W., Krishnan, A., Kain, T., & Raboud, J. (2017). Metabolic syndrome in HIV: A systematic review. PLoS ONE, 12(3), e0174053.
MacInnes, A., Adriano Lazzarin, Giovanni Di Perri, Sierra-Madero, J., Aberg, J. A., Jayvant Heera, Natasa Rajicic, Goodrich, J., Mayer, H., & Valdez, H. (2011). Maraviroc Can Improve Lipid Profiles in Dyslipidemic Patients with HIV: Results from the MERIT Trial. 12(1), 24–36. https://doi.org/10.1310/hct1201-24
MANEJO DA INFECÇÃO PELO HIV EM ADULTOS MÓDULO I TRATAMENTO. (n.d.). https://www.gov.br/aids/pt-br/central-de-conteudo/pcdts/pcdt_hiv_modulo_1_2024.pdf
Masenga, S. K., Elijovich, F., Koethe, J. R., Hamooya, B. M., Heimburger, D. C., Munsaka, S. M., Laffer, C. L., & Kirabo, A. (2020). Hypertension and Metabolic Syndrome in Persons with HIV. Current Hypertension Reports, 22(10), 78. https://doi.org/10.1007/s11906-020-01089-3
McComsey, G. A., Kitch, D., Sax, P. E., Tierney, C., Jahed, N. C., Melbourne, K., ... & Daar, E. S. (2016). Peripheral and central fat changes in ART-naïve adults randomized to abacavir-lamivudine or tenofovir-emtricitabine with atazanavir-ritonavir or efavirenz: ACTG Study A5224s. Clinical Infectious Diseases, 63(5), 636-646.
Nansseu, J. R., Bigna, J. J., Kaze, A. D., & Noubiap, J. J. (2018). Incidence and Risk Factors for Prediabetes and Diabetes Mellitus Among HIV-infected Adults on Antiretroviral Therapy. Epidemiology, 29(3), 431–441. https://doi.org/10.1097/ede.0000000000000815
Nduka, C. U., Stranges, S., Kimani, P. K., Sarki, A. M., & Uthman, O. A. (2017). Is there sufficient evidence for a causal association between antiretroviral therapy and diabetes in HIV-infected patients? A meta-analysis. Diabetes/Metabolism Research and Reviews, 33(6), e2902. https://doi.org/10.1002/dmrr.2902
Overton, E. T., Tebas, P., Coate, B., Ryan, R., Perniciaro, A., Dayaram, Y. K., De, G., & Baugh, B. P. (2016). Effects of once-daily darunavir/ritonavir versus atazanavir/ritonavir on insulin sensitivity in HIV-infected persons over 48 weeks: results of an exploratory substudy of METABOLIK, a phase 4, randomized trial. HIV Clinical Trials, 17(2), 72–77. https://doi.org/10.1080/15284336.2016.1141468
Palmer, C. S., Hussain, T., Duette, G., Weller, T. J., Ostrowski, M., Sada-Ovalle, I., & Crowe, S. M. (2015). Regulators of Glucose Metabolism in CD4+ and CD8+ T Cells. International Reviews of Immunology, 35(6), 477–488. https://doi.org/10.3109/08830185.2015.1082178
Papantoniou, E., Arvanitakis, K., Markakis, K., Papadakos, S. P., Tsachouridou, O., Popovic, D. S., Germanidis, G., Koufakis, T., & Kotsa, K. (2024). Pathophysiology and Clinical Management of Dyslipidemia in People Living with HIV: Sailing through Rough Seas. Life, 14(4), 449. https://doi.org/10.3390/life14040449
Raposo, M. A., Armiliato, G. N. de A., Guimarães, N. S., Caram, C. A., Silveira, R. D. de S., & Tupinambás, U. (2017). Metabolic disorders and cardiovascular risk in people living with HIV/AIDS without the use of antiretroviral therapy. Revista Da Sociedade Brasileira de Medicina Tropical, 50(5), 598–606. https://doi.org/10.1590/0037-8682-0258-2017
Relatório Global 2024 - UNAIDS Brasil. (2024). Unaids.org.br. https://unaids.org.br/tag/relatorio-global-2024/
Saboya, P. P., Bodanese, L. C., Zimmermann, P. R., Gustavo, A. da S., Assumpção, C. M., & Londero, F. (2016). Síndrome metabólica e qualidade de vida: uma revisão sistemática. Revista Latino-Americana de Enfermagem, 24, e2848. https://www.scielo.br/j/rlae/a/5V6yFK6MCNcmtxwH8DYYGRP/?lang=pt
Sax, P. E., Erlandson, K. M., Lake, J. E., Mccomsey, G. A., Orkin, C., Esser, S., Brown, T. T., Rockstroh, J. K., Wei, X., Carter, C. C., Zhong, L., Brainard, D. M., Melbourne, K., Das, M., Stellbrink, H.-J., Post, F. A., Waters, L., & Koethe, J. R. (2019). Weight Gain Following Initiation of Antiretroviral Therapy: Risk Factors in Randomized Comparative Clinical Trials. Clinical Infectious Diseases. https://doi.org/10.1093/cid/ciz999
Silva, É. F. R. da, Bassichetto, K. C., & Lewi, D. S. (2009). Perfil lipídico, fatores de risco cardiovascular e síndrome metabólica em um grupo de pacientes com AIDS. Arquivos Brasileiros de Cardiologia, 93(2). https://doi.org/10.1590/s0066-782x2009000800008
Soares, L. R., Menezes, G. C., Barreto, A. P. M., Sant’Anna, M. de S. L., Cardoso, N. M. A., Casseb, J. S. do R., & Fonseca, F. L. A. (2020). Association between changes in body fat distribution, biochemical profile, time of HIV diagnosis, and antiretroviral treatment in adults living with and without virus infection. Revista Da Associação Médica Brasileira, 66(1), 67–73. https://doi.org/10.1590/1806-9282.66.1.67
Sociedade Brasileira de Hipertensão, Sociedade Brasileira de Cardiologia, Sociedade Brasileira de Endocrinologia e Metabologia, Sociedade Brasileira de Diabetes, & Sociedade Brasileira de Estudos da Obesidade. (2005). [I Brazilian guidelines on diagnosis and treatment of metabolic syndrome]. Arquivos Brasileiros de Cardiologia, 84 Suppl 1, 1–28. https://pubmed.ncbi.nlm.nih.gov/16095065/
Tesfaye, D. Y., Kinde, S., Reta, M. M., Tessema, G. A., Alene, K. A., & Assefa, N. (2018). Metabolic syndrome among HIV-infected patients in Africa: A systematic review and meta-analysis. PLoS ONE, 13(3), e0192989.
Valenzuela-Rodriguez, G., Diaz-Arocutipa, C., Collins, J. A., & Hernandez, A. V. (2023). Weight and Metabolic Outcomes in Naïve HIV Patients Treated with Integrase Inhibitor-Based Antiretroviral Therapy: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine, 12(11), 3644. https://doi.org/10.3390/jcm12113644
Willig, A. L., & Overton, E. T. (2016). Metabolic Complications and Glucose Metabolism in HIV Infection: A Review of the Evidence. Current HIV/AIDS Reports, 13(5), 289–296. https://doi.org/10.1007/s11904-016-0330-z
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Virna Costa dos Santos; José Roberto Gomes Francilino Filho; Amanda Almeida Lima; Luan Victor Almeida Lima
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
