An observational study of the prevalence of metabolic syndrome in treatment-experienced people living with HIV in Singapore

Background: While the use of combination antiretroviral therapy (cART) has conferred significant reduction in morbidity and mortality, there are growing concerns about the metabolic complications of antiretroviral regimens in HIV-infected patients. The aim of this study was to estimate the prevalenc...

Full description

Saved in:
Bibliographic Details
Main Authors: Ang, Li Wei, Ng, Oon Tek, Boudville, Irving Charles, Leo, Yee Sin, Wong, Chen Seong
Other Authors: Lee Kong Chian School of Medicine (LKCMedicine)
Format: Article
Language:English
Published: 2021
Subjects:
Online Access:https://hdl.handle.net/10356/152029
Tags: Add Tag
No Tags, Be the first to tag this record!
Institution: Nanyang Technological University
Language: English
id sg-ntu-dr.10356-152029
record_format dspace
spelling sg-ntu-dr.10356-1520292023-03-05T16:43:53Z An observational study of the prevalence of metabolic syndrome in treatment-experienced people living with HIV in Singapore Ang, Li Wei Ng, Oon Tek Boudville, Irving Charles Leo, Yee Sin Wong, Chen Seong Lee Kong Chian School of Medicine (LKCMedicine) National Centre for Infectious Diseases Tan Tock Seng Hospital Science::Medicine Metabolic Syndrome Human Immunodeficiency Virus Background: While the use of combination antiretroviral therapy (cART) has conferred significant reduction in morbidity and mortality, there are growing concerns about the metabolic complications of antiretroviral regimens in HIV-infected patients. The aim of this study was to estimate the prevalence of metabolic syndrome (MetS) among people living with HIV (PLHIV) in Singapore. Methods: We conducted a retrospective study using the clinical database maintained by the Clinical HIV Programme at the National Centre for Infectious Diseases, Singapore. Treatment-experienced PLHIV on follow-up during 2015–2017 were included. MetS was defined as having three or more of the following five abnormalities: hypertriglyceridemia, HDL hypocholesterolemia, hypertension, obesity, and diabetes. Results: A total of 2,231 PLHIV were included in this study. 93.9% were men, and the median age at latest follow-up was 48 years. The median duration of HIV infection and duration of exposure to cART was 6.8 years and 5.7 years, respectively. All had been exposed to nucleoside reverse transcriptase inhibitors (NRTIs) as the first line of treatment, 93.9% to non-NRTIs, 28.6% to protease inhibitors (PIs) and 12.8% to integrase strand transfer inhibitors. The most common metabolic abnormality among PLHIV was HDL hypocholesterolemia (60.2%) followed by hypertriglyceridemia (45.5%). Of all the 2,231 individuals, 68.8% had at least one component of MetS. The overall prevalence of MetS was 23.6% (95% confidence interval 21.9%–25.4%). Of the 526 with MetS, the most common combination was HDL hypocholesterolemia, hypertriglyceridemia and hypertension (51.0%), followed by HDL hypocholesterolemia, hypertriglyceridemia, hypertension and diabetes (25.1%). Compared with PLHIV without MetS, a significantly higher proportion of those with MetS were ever on protease inhibitors (33.5% vs. 27.1%). Conclusion: MetS is common in PLHIV. In view of the progressive aging of HIV-infected population and long-term use of cART, regular monitoring for metabolic abnormalities, surveillance of drug effects and behavioural interventions are needed to optimize management and prevention of metabolic disorders in PLHIV. National Medical Research Council (NMRC) Published version This work was supported by the National Medical Research Council (NMRC) in the form of a Clinician Scientist Award granted to Oon Tek Ng (MOH-000276). 2021-11-17T07:49:51Z 2021-11-17T07:49:51Z 2021 Journal Article Ang, L. W., Ng, O. T., Boudville, I. C., Leo, Y. S. & Wong, C. S. (2021). An observational study of the prevalence of metabolic syndrome in treatment-experienced people living with HIV in Singapore. PloS ONE, 16(6), e0252320-. https://dx.doi.org/10.1371/journal.pone.0252320 1932-6203 https://hdl.handle.net/10356/152029 10.1371/journal.pone.0252320 34077481 2-s2.0-85107172295 6 16 e0252320 en MOH-00027 PloS ONE © 2021 Ang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. application/pdf
institution Nanyang Technological University
building NTU Library
continent Asia
country Singapore
Singapore
content_provider NTU Library
collection DR-NTU
language English
topic Science::Medicine
Metabolic Syndrome
Human Immunodeficiency Virus
spellingShingle Science::Medicine
Metabolic Syndrome
Human Immunodeficiency Virus
Ang, Li Wei
Ng, Oon Tek
Boudville, Irving Charles
Leo, Yee Sin
Wong, Chen Seong
An observational study of the prevalence of metabolic syndrome in treatment-experienced people living with HIV in Singapore
description Background: While the use of combination antiretroviral therapy (cART) has conferred significant reduction in morbidity and mortality, there are growing concerns about the metabolic complications of antiretroviral regimens in HIV-infected patients. The aim of this study was to estimate the prevalence of metabolic syndrome (MetS) among people living with HIV (PLHIV) in Singapore. Methods: We conducted a retrospective study using the clinical database maintained by the Clinical HIV Programme at the National Centre for Infectious Diseases, Singapore. Treatment-experienced PLHIV on follow-up during 2015–2017 were included. MetS was defined as having three or more of the following five abnormalities: hypertriglyceridemia, HDL hypocholesterolemia, hypertension, obesity, and diabetes. Results: A total of 2,231 PLHIV were included in this study. 93.9% were men, and the median age at latest follow-up was 48 years. The median duration of HIV infection and duration of exposure to cART was 6.8 years and 5.7 years, respectively. All had been exposed to nucleoside reverse transcriptase inhibitors (NRTIs) as the first line of treatment, 93.9% to non-NRTIs, 28.6% to protease inhibitors (PIs) and 12.8% to integrase strand transfer inhibitors. The most common metabolic abnormality among PLHIV was HDL hypocholesterolemia (60.2%) followed by hypertriglyceridemia (45.5%). Of all the 2,231 individuals, 68.8% had at least one component of MetS. The overall prevalence of MetS was 23.6% (95% confidence interval 21.9%–25.4%). Of the 526 with MetS, the most common combination was HDL hypocholesterolemia, hypertriglyceridemia and hypertension (51.0%), followed by HDL hypocholesterolemia, hypertriglyceridemia, hypertension and diabetes (25.1%). Compared with PLHIV without MetS, a significantly higher proportion of those with MetS were ever on protease inhibitors (33.5% vs. 27.1%). Conclusion: MetS is common in PLHIV. In view of the progressive aging of HIV-infected population and long-term use of cART, regular monitoring for metabolic abnormalities, surveillance of drug effects and behavioural interventions are needed to optimize management and prevention of metabolic disorders in PLHIV.
author2 Lee Kong Chian School of Medicine (LKCMedicine)
author_facet Lee Kong Chian School of Medicine (LKCMedicine)
Ang, Li Wei
Ng, Oon Tek
Boudville, Irving Charles
Leo, Yee Sin
Wong, Chen Seong
format Article
author Ang, Li Wei
Ng, Oon Tek
Boudville, Irving Charles
Leo, Yee Sin
Wong, Chen Seong
author_sort Ang, Li Wei
title An observational study of the prevalence of metabolic syndrome in treatment-experienced people living with HIV in Singapore
title_short An observational study of the prevalence of metabolic syndrome in treatment-experienced people living with HIV in Singapore
title_full An observational study of the prevalence of metabolic syndrome in treatment-experienced people living with HIV in Singapore
title_fullStr An observational study of the prevalence of metabolic syndrome in treatment-experienced people living with HIV in Singapore
title_full_unstemmed An observational study of the prevalence of metabolic syndrome in treatment-experienced people living with HIV in Singapore
title_sort observational study of the prevalence of metabolic syndrome in treatment-experienced people living with hiv in singapore
publishDate 2021
url https://hdl.handle.net/10356/152029
_version_ 1759858385011867648