Comparison of cardiometabolic risk profile between HIV patients on art and those who are art naïve

Background: Metabolic syndrome comprises of a set of aggregated risk factors that include: hypertension, central obesity, impaired fasting glucose, hypertriglyceridemia and low HDL-C (1)The is a noted increase in the prevalence of the metabolic syndrome cardiovascular risk factors in the HIV population. Methods: The study is a cross-sectional survey that enrolled 157 HIV positive patients over a 4 month period that were either newly diagnosed (HIV ART naïve) or were on ART from both the inpatient and outpatient setting. Data of their anthropometric, cardiovascular risk factors and clinical characteristics were collected with the aid of a standardized questionnaire and serum biochemical testing was done in the fasted state. The data obtained was used to determine the presence or absence of the metabolic syndrome in the two populations using the NCEP ATP III criteria and their 10 year risk of adverse cardiovascular outcome using the WHO/ISH AFRI E score. Results: The mean age of the study participants was 46 years S.D (9.3). The prevalence of metabolic syndrome was 23.75% and 11.69% in the ART arm and ART naïve arm respectively. Majority of the patients were in the low risk category as calculated by the WHO/ISH AFRI E score 89.61% vs. 91.25% in the naïve and ART arms respectively. 6.49% and 3.89% in HIV ART naïve arm were distributed in the moderate and very high risk categories as compared 6.25% and 2.5% in the HIV ART arm. Conclusions and recommendations: Metabolic syndrome was found to be more prevalent in the HIV ART arm as compared to the naïve arm although the difference did not reach a statistically significant level. Majority of the individuals as by WHO/ISH AFRI E risk score in both arms were found to be in the low risk category and thus would greatly benefit from diet and lifestyle modification to avert the risk of developing metabolic syndrome and subsequent cardiovascular disease.