Metabolic syndrome among treatment‐naïve people living with and without HIV in Zambia and Zimbabwe: a cross‐sectional analysis
Abstract Introduction Chronic viral replication has been linked to an increased risk of cardiovascular and metabolic diseases in people living with HIV (PLWH), but few studies have evaluated this association in Southern Africa. We explored the determinants of metabolic syndrome (MetS) among treatmen...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-12-01
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| Series: | Journal of the International AIDS Society |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jia2.26047 |
| _version_ | 1828085924195467264 |
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| author | Belinda V. Chihota Ardele Mandiriri Tinei Shamu Guy Muula Hellen Nyamutowa Charlotte Taderera Daniel Mwamba Roma Chilengi Carolyn Bolton‐Moore Samuel Bosomprah Matthias Egger Cleophas Chimbetete Gilles Wandeler for IeDEA Southern Africa |
| author_facet | Belinda V. Chihota Ardele Mandiriri Tinei Shamu Guy Muula Hellen Nyamutowa Charlotte Taderera Daniel Mwamba Roma Chilengi Carolyn Bolton‐Moore Samuel Bosomprah Matthias Egger Cleophas Chimbetete Gilles Wandeler for IeDEA Southern Africa |
| author_sort | Belinda V. Chihota |
| collection | DOAJ |
| description | Abstract Introduction Chronic viral replication has been linked to an increased risk of cardiovascular and metabolic diseases in people living with HIV (PLWH), but few studies have evaluated this association in Southern Africa. We explored the determinants of metabolic syndrome (MetS) among treatment‐naïve adults living with and without HIV in Southern Africa. Methods Treatment‐naïve PLWH and people living without HIV (PLWOH) ≥30 years were consecutively enrolled from primary care clinics in Zambia and Zimbabwe. PLWOH were seronegative partners or persons presenting for HIV testing. We defined MetS as the presence of central obesity plus any two of the following: raised blood pressure, impaired fasting glucose, reduced high‐density lipoprotein cholesterol and raised triglycerides, as defined by the International Diabetes Federation. We used logistic regression to determine factors associated with MetS. Results Between August 2019 and March 2022, we screened 1285 adults and enrolled 420 (47%) PLWH and 481 (53%) PLWOH. The median age was similar between PLWH and PLWOH (40 vs. 38 years, p < 0.24). In PLWH, the median CD4+ count was 228 cells/mm3 (IQR 108–412) and the viral load was 24,114 copies/ml (IQR 277–214,271). Central obesity was present in 365/523 (70%) females and 57/378 males (15%). MetS was diagnosed in 172/901 (19%, 95% confidence interval [CI] 17–22%), and prevalence was higher among females than males (27% vs. 9%). In multivariable analyses, HIV status was not associated with MetS (adjusted odds ratio [aOR] 1.05, 95% CI 0.74–1.51). Risk factors for MetS included age older than 50 years (aOR 2.31, 95% CI 1.49–3.59), female sex (aOR 3.47, 95% CI 2.15–5.60), highest income (aOR 2.19, 95% CI 1.39–3.44) and less than World Health Organization recommended weekly physical activity (aOR 3.35, 95% CI 1.41–7.96). Conclusions We report a high prevalence of MetS and central obesity among females in urban Zambia and Zimbabwe. Lifestyle factors and older age appear to be the strongest predictors of MetS in our population, with no evident difference in MetS prevalence between treatment‐naïve PLWH and PLWOH. |
| first_indexed | 2024-04-11T04:47:36Z |
| format | Article |
| id | doaj.art-41b1fc023b0646e696a233c32bc130bf |
| institution | Directory Open Access Journal |
| issn | 1758-2652 |
| language | English |
| last_indexed | 2024-04-11T04:47:36Z |
| publishDate | 2022-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the International AIDS Society |
| spelling | doaj.art-41b1fc023b0646e696a233c32bc130bf2022-12-27T08:56:30ZengWileyJournal of the International AIDS Society1758-26522022-12-012512n/an/a10.1002/jia2.26047Metabolic syndrome among treatment‐naïve people living with and without HIV in Zambia and Zimbabwe: a cross‐sectional analysisBelinda V. Chihota0Ardele Mandiriri1Tinei Shamu2Guy Muula3Hellen Nyamutowa4Charlotte Taderera5Daniel Mwamba6Roma Chilengi7Carolyn Bolton‐Moore8Samuel Bosomprah9Matthias Egger10Cleophas Chimbetete11Gilles Wandeler12for IeDEA Southern AfricaCentre for Infectious Disease Research LusakaZambiaNewlands Clinic HarareZimbabweGraduate School of Health SciencesUniversity of Bern BernSwitzerlandCentre for Infectious Disease Research LusakaZambiaNewlands Clinic HarareZimbabweNewlands Clinic HarareZimbabweCentre for Infectious Disease Research LusakaZambiaCentre for Infectious Disease Research LusakaZambiaCentre for Infectious Disease Research LusakaZambiaCentre for Infectious Disease Research LusakaZambiaInstitute of Social and Preventive MedicineUniversity of Bern BernSwitzerlandNewlands Clinic HarareZimbabweInstitute of Social and Preventive MedicineUniversity of Bern BernSwitzerlandAbstract Introduction Chronic viral replication has been linked to an increased risk of cardiovascular and metabolic diseases in people living with HIV (PLWH), but few studies have evaluated this association in Southern Africa. We explored the determinants of metabolic syndrome (MetS) among treatment‐naïve adults living with and without HIV in Southern Africa. Methods Treatment‐naïve PLWH and people living without HIV (PLWOH) ≥30 years were consecutively enrolled from primary care clinics in Zambia and Zimbabwe. PLWOH were seronegative partners or persons presenting for HIV testing. We defined MetS as the presence of central obesity plus any two of the following: raised blood pressure, impaired fasting glucose, reduced high‐density lipoprotein cholesterol and raised triglycerides, as defined by the International Diabetes Federation. We used logistic regression to determine factors associated with MetS. Results Between August 2019 and March 2022, we screened 1285 adults and enrolled 420 (47%) PLWH and 481 (53%) PLWOH. The median age was similar between PLWH and PLWOH (40 vs. 38 years, p < 0.24). In PLWH, the median CD4+ count was 228 cells/mm3 (IQR 108–412) and the viral load was 24,114 copies/ml (IQR 277–214,271). Central obesity was present in 365/523 (70%) females and 57/378 males (15%). MetS was diagnosed in 172/901 (19%, 95% confidence interval [CI] 17–22%), and prevalence was higher among females than males (27% vs. 9%). In multivariable analyses, HIV status was not associated with MetS (adjusted odds ratio [aOR] 1.05, 95% CI 0.74–1.51). Risk factors for MetS included age older than 50 years (aOR 2.31, 95% CI 1.49–3.59), female sex (aOR 3.47, 95% CI 2.15–5.60), highest income (aOR 2.19, 95% CI 1.39–3.44) and less than World Health Organization recommended weekly physical activity (aOR 3.35, 95% CI 1.41–7.96). Conclusions We report a high prevalence of MetS and central obesity among females in urban Zambia and Zimbabwe. Lifestyle factors and older age appear to be the strongest predictors of MetS in our population, with no evident difference in MetS prevalence between treatment‐naïve PLWH and PLWOH.https://doi.org/10.1002/jia2.26047metabolic syndromeHIV epidemiologyAfricawomenpublic healthrisk factors |
| spellingShingle | Belinda V. Chihota Ardele Mandiriri Tinei Shamu Guy Muula Hellen Nyamutowa Charlotte Taderera Daniel Mwamba Roma Chilengi Carolyn Bolton‐Moore Samuel Bosomprah Matthias Egger Cleophas Chimbetete Gilles Wandeler for IeDEA Southern Africa Metabolic syndrome among treatment‐naïve people living with and without HIV in Zambia and Zimbabwe: a cross‐sectional analysis Journal of the International AIDS Society metabolic syndrome HIV epidemiology Africa women public health risk factors |
| title | Metabolic syndrome among treatment‐naïve people living with and without HIV in Zambia and Zimbabwe: a cross‐sectional analysis |
| title_full | Metabolic syndrome among treatment‐naïve people living with and without HIV in Zambia and Zimbabwe: a cross‐sectional analysis |
| title_fullStr | Metabolic syndrome among treatment‐naïve people living with and without HIV in Zambia and Zimbabwe: a cross‐sectional analysis |
| title_full_unstemmed | Metabolic syndrome among treatment‐naïve people living with and without HIV in Zambia and Zimbabwe: a cross‐sectional analysis |
| title_short | Metabolic syndrome among treatment‐naïve people living with and without HIV in Zambia and Zimbabwe: a cross‐sectional analysis |
| title_sort | metabolic syndrome among treatment naive people living with and without hiv in zambia and zimbabwe a cross sectional analysis |
| topic | metabolic syndrome HIV epidemiology Africa women public health risk factors |
| url | https://doi.org/10.1002/jia2.26047 |
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