Prevalence and factors associated with metabolic syndrome among ART Naïve people living with HIV in Accra, Ghana: a multicenter cross-sectional study.

Abstract

Background: To inform strategies aimed at reducing Metabolic Syndrome (MetS) among People Living with HIV (PLWH), it is important to understand the contribution of pre-Antiretroviral Therapy (ART) health. We estimated the prevalence and factors associated with MetS among ART naïve PLWH.

Methods: A multi-centre cross-sectional study was conducted among adult ART naïve PLWH. MetS was defined as presence of any three sub-components; central obesity, raised blood pressure, impaired fasting glucose, reduced high-density lipoprotein cholesterol and raised triglycerides. Modified World Health Organization (WHO) Steps questionnaire was used to collect information on demographics, behavioral, and physical measurements. Fasting blood samples were taken for blood sugar, high density lipoprotein cholesterol (HDLc) and triglyceride measurements. MetS prevalence was estimated and logistic regression used to determine associated factors. Adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) were reported.

Results: Of 347 ART naïve PLWH with median age 38 years (IQR:19-67), MetS prevalence was at 15.3% (95% CI: 11.7-19.5). Abnormal HDLc was the most prevalent MetS sub-component 64.8% (95% CI: 59.6-69.9). Each year increase in age of participants increased odds of Mets by 4% (aOR = 1.04, 95% CI: 1.01-1.07). Being overweight/obese increased the odds of having MetS by 3.2 times compared to being of healthy weight (aOR = 3.2, 95% CI: 1.6-6.3).

Conclusion: We found that about one in seven ART Naïve PLWH in Accra, Ghana, met the diagnostic criteria for MetS. The contributory factors were consistent with known risk factors for cardiometabolic illnesses. We recommend routine screening of PLWH for MetS sub-components.