Yusufu Innocent, Nagu Tumaini, Ottaru Theresia A, Sando Mary Mmwanyika, Kaaya Sylvia, Mbugi Erasto, Hirschhorn Lisa R, Hawkins Claudia
Africa Academy for Public Health (AAPH).
Muhimbili University of Health and Allied Sciences.
Res Sq. 2024 May 15:rs.3.rs-4372785. doi: 10.21203/rs.3.rs-4372785/v1.
Adults living with HIV (ALHIV) are at increased risk of developing metabolic syndrome (MetS). Several factors are associated with an increase in MetS in these individuals, including certain antiretroviral therapies (ART). There is limited data on the prevalence of MetS among ALHIV in sub-Saharan Africa following scale up of newer integrase inhibitor-containing ART regimens.
We assessed the prevalence and correlates of MetS among ALHIV patients receiving tenofovir, lamivudine, and dolutegravir (TLD) in Tanzania.
We conducted a retrospective cross-sectional analysis of ALHIV aged ≥18 enrolled in a cardiovascular health study at six HIV Care and Treatment Clinics from 11/2020-1/2021 in Dar es Salaam, Tanzania. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). Descriptive statistics were used to summarize the results, and logistic regression was used to assess demographic, behavioral, and HIV-related risk factors associated with MetS. Covariates with a p-value <0.2 at the univariate level were included in the multivariate model.
Three hundred and eighty nine participants were included in the analysis. The mean age (SD) was 43 years (±11) years, and 286 (73.5%) were female. The prevalence of MetS in this population was 21%. In univariate analysis, MetS components that were significantly higher among women vs. men included abdominal obesity (27.3% vs. 4.9%), reduced HDL (77.9% vs. 53.4%), and elevated glucose (18.5% vs. 14.6%), all p< 0.05. Age≥ 50 yrs [AOR 3.25; (95% CI 1.80-5.84), p < 0.01] and BMI [AOR 0.16; (95% CI 0.09-0.30), P ≤0.01] were both associated with an increased odds of MetS in multivariate analyses.
MetS. is prevalent among Tanzanian ALHIV on TLD. Routine screening for MetS and healthy lifestyle promotion, particularly among women and those aging, should be a priority to prevent against cardiovascular disease. Further studies are needed to monitor the long-term impact of these newer ART regimens on MetS and CVD.
感染艾滋病毒的成年人（ALHIV）患代谢综合征（MetS）的风险增加。有几个因素与这些个体中MetS的增加有关，包括某些抗逆转录病毒疗法（ART）。在撒哈拉以南非洲扩大含新型整合酶抑制剂的ART方案后，关于ALHIV中MetS患病率的数据有限。
我们评估了坦桑尼亚接受替诺福韦、拉米夫定和多替拉韦（TLD）治疗的ALHIV患者中MetS的患病率及其相关因素。
我们对2020年11月至2021年1月在坦桑尼亚达累斯萨拉姆的六个艾滋病毒护理和治疗诊所参加心血管健康研究的年龄≥18岁的ALHIV进行了回顾性横断面分析。MetS根据美国国家胆固醇教育计划成人治疗小组III（NCEP ATP III）进行定义。使用描述性统计来总结结果，并使用逻辑回归来评估与MetS相关的人口统计学、行为和艾滋病毒相关风险因素。单变量水平上p值<0.2的协变量被纳入多变量模型。
389名参与者被纳入分析。平均年龄（标准差）为43岁（±11岁），286名（73.5%）为女性。该人群中MetS的患病率为21%。在单变量分析中，女性中显著高于男性的MetS组成部分包括腹型肥胖（27.3%对4.9%）、HDL降低（77.9%对53.4%）和血糖升高（18.5%对14.6%），所有p<0.05。在多变量分析中，年龄≥50岁[AOR 3.25；（95%CI 1.80-5.84），p<0.01]和BMI[AOR 0.16；（95%CI 0.09-0.30），P≤0.01]均与MetS的患病几率增加相关。
MetS在坦桑尼亚接受TLD治疗的ALHIV中很普遍。对MetS进行常规筛查和促进健康的生活方式，特别是在女性和老年人中，应作为预防心血管疾病的优先事项。需要进一步研究来监测这些新型ART方案对MetS和心血管疾病的长期影响。
