Original articleMetabolic syndrome: A major risk factor for atherosclerosis in HIV-infected patients (SHIVA study)Le syndrome métabolique : un risque cardiovasculaire majeur chez les patients séropositifs pour le VIH
Section snippets
What was already known
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The high incidence of cardiovascular disease among people with HIV infection.
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The high prevalence of metabolic syndrome in people with HIV infection.
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The direct relation between metabolic syndrome and cardiovascular disease in the general population.
What this article adds
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The prevalence of MetS (10.9%) was much lower than previously reported in patients with HIV but remained higher than among the general population (4.8%).
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Metabolic syndrome status depends on a combination of adverse events due to antiretroviral treatment and HIV-associated dysfunctions.
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MetS status was strongly linked to cardiovascular disease markers and can be used for determining the need for primary cardiovascular prevention.
Methods
The cross-sectional SHIVA study [5], which was approved by the local ethics committee, enrolled 154 (96.5%) patients from a cohort of HIV outpatients under follow-up at Brest University Hospital (figure 1). This study took place from January through April 2003. After patients provided informed consent, the following information was collected:
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blood levels (after overnight fast, > 12 hours) of triglycerides, glucose, total cholesterol, HDL cholesterol [HDL-C]
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anthropometric and other clinical data:
Results
MetS status was available for 140 patients (86.9%). Ten patients (7.1%) met the NCEP definition. Positive status for MetS was strongly correlated with all atherosclerosis markers (p ≤ 0.01). Only age, total cholesterol, and BMI, of the MetS-independent atherosclerosis risk factors, and viral load, of the HIV parameters, were correlated with MetS status (table I). An interaction (p > 0.05) was observed between the variables correlated with MetS status. Moreover, MetS status was not associated with
Discussion
Despite the inclusion of 6 patients with a history of CVD (10.9%), the prevalence of MetS (7.4%) was much lower than those previously reported in HIV-infected patients — ranging from 17% to 45% [8], [9], [10]. Nevertheless it is higher than MetS prevalence in the French general population, reported to be 4.8% [11] for a population of the same age and using the same definition as the Spanish HIV patient cohort with a prevalence of 17% [10].
This low prevalence is not explained by a high rate of
Conflicts of Interest
none
Funding
This project received funding from a PHRC 2003 grant.
Remarks
The SHIVA study was approved by the Brest institutional review board (CCPPRB). The database has been reported to the French Data Protection Authority (CNIL), as required by statute.
Luc de Saint Martin designed the study, analyzed the data and participated in writing the paper
Elisabeth Pasquier analyzed the data and participated in writing the paper
Nathalie Roudaut participated in writing the paper.
Olivier Vandhuick (IMT), Sophie Vallet (HIV status), Véronique Bellein (lipodystrophy) and Luc
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