A meta-analysis of the Metabolic Syndrome prevalence in the global HIV-infected population

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dc.contributor.authorNguyen, Kim Aen_ZA
dc.contributor.authorPeer, Nasheetaen_ZA
dc.contributor.authorMills, Edward Jen_ZA
dc.contributor.authorKengne, Andre Pen_ZA
dc.date.accessioned2016-04-13T12:38:05Z
dc.date.available2016-04-13T12:38:05Z
dc.date.issued2016en_ZA
dc.description.abstractBACKGROUND: Cardio-metabolic risk factors are of increasing concern in HIV-infected individuals, particularly with the advent of antiretroviral therapy (ART) and the subsequent rise in longevity. However, the prevalence of cardio-metabolic abnormalities in this population and the differential contribution, if any, of HIV specific factors to their distribution, are poorly understood. Therefore, we conducted a systematic review and meta-analysis to estimate the global prevalence of metabolic syndrome (MS) in HIV-infected populations, its variation by the different diagnostic criteria, severity of HIV infection, ART used and other major predictive characteristics. METHODS: We performed a comprehensive search on major databases for original research articles published between 1998 and 2015. The pooled overall prevalence as well as by specific groups and subgroups were computed using random effects models. RESULTS: A total of 65 studies across five continents comprising 55094 HIV-infected participants aged 17-73 years (median age 41 years) were included in the final meta-analysis. The overall prevalence of MS according to the following criteria were: ATPIII-2001:16.7% (95%CI: 14.6-18.8), IDF-2005: 18% (95%CI: 14.0-22.4), ATPIII-2004-2005: 24.6% (95%CI: 20.6-28.8), Modified ATPIII-2005: 27.9% (95%CI: 6.7-56.5), JIS-2009: 29.6% (95%CI: 22.9-36.8), and EGIR: 31.3% (95%CI: 26.8-36.0). By some MS criteria, the prevalence was significantly higher in women than in men (IDF-2005: 23.2% vs. 13.4, p = 0.030), in ART compared to non-ART users (ATPIII-2001: 18.4% vs. 11.8%, p = 0.001), and varied significantly by participant age, duration of HIV diagnosis, severity of infection, non-nucleoside reverse transcriptase inhibitors (NNRTIs) use and date of study publication. Across criteria, there were significant differences in MS prevalence by sub-groups such as in men, the Americas, older publications, regional studies, younger adults, smokers, ART-naïve participants, NNRTIs users, participants with shorter duration of diagnosed infection and across the spectrum of HIV severity. Substantial heterogeneities across and within criteria were not fully explained by major study characteristics, while evidence of publication bias was marginal. CONCLUSIONS: The similar range of MS prevalence in the HIV-infected and general populations highlights the common drivers of this condition. Thus, cardio-metabolic assessments need to be routinely included in the holistic management of the HIV-infected individual. Management strategies recommended for MS in the general population will likely provide similar benefits in the HIV-infected.en_ZA
dc.identifier.apacitationNguyen, K. A., Peer, N., Mills, E. J., & Kengne, A. P. (2016). A meta-analysis of the Metabolic Syndrome prevalence in the global HIV-infected population. <i>PLoS One</i>, http://hdl.handle.net/11427/18859en_ZA
dc.identifier.chicagocitationNguyen, Kim A, Nasheeta Peer, Edward J Mills, and Andre P Kengne "A meta-analysis of the Metabolic Syndrome prevalence in the global HIV-infected population." <i>PLoS One</i> (2016) http://hdl.handle.net/11427/18859en_ZA
dc.identifier.citationNguyen, K. A., Peer, N., Mills, E. J., & Kengne, A. P. (2016). A meta-analysis of the Metabolic Syndrome prevalence in the global HIV-infected population. PloS one, 11(3), e0150970. doi:10.1371/journal.pone.0150970en_ZA
dc.identifier.ris TY - Journal Article AU - Nguyen, Kim A AU - Peer, Nasheeta AU - Mills, Edward J AU - Kengne, Andre P AB - BACKGROUND: Cardio-metabolic risk factors are of increasing concern in HIV-infected individuals, particularly with the advent of antiretroviral therapy (ART) and the subsequent rise in longevity. However, the prevalence of cardio-metabolic abnormalities in this population and the differential contribution, if any, of HIV specific factors to their distribution, are poorly understood. Therefore, we conducted a systematic review and meta-analysis to estimate the global prevalence of metabolic syndrome (MS) in HIV-infected populations, its variation by the different diagnostic criteria, severity of HIV infection, ART used and other major predictive characteristics. METHODS: We performed a comprehensive search on major databases for original research articles published between 1998 and 2015. The pooled overall prevalence as well as by specific groups and subgroups were computed using random effects models. RESULTS: A total of 65 studies across five continents comprising 55094 HIV-infected participants aged 17-73 years (median age 41 years) were included in the final meta-analysis. The overall prevalence of MS according to the following criteria were: ATPIII-2001:16.7% (95%CI: 14.6-18.8), IDF-2005: 18% (95%CI: 14.0-22.4), ATPIII-2004-2005: 24.6% (95%CI: 20.6-28.8), Modified ATPIII-2005: 27.9% (95%CI: 6.7-56.5), JIS-2009: 29.6% (95%CI: 22.9-36.8), and EGIR: 31.3% (95%CI: 26.8-36.0). By some MS criteria, the prevalence was significantly higher in women than in men (IDF-2005: 23.2% vs. 13.4, p = 0.030), in ART compared to non-ART users (ATPIII-2001: 18.4% vs. 11.8%, p = 0.001), and varied significantly by participant age, duration of HIV diagnosis, severity of infection, non-nucleoside reverse transcriptase inhibitors (NNRTIs) use and date of study publication. Across criteria, there were significant differences in MS prevalence by sub-groups such as in men, the Americas, older publications, regional studies, younger adults, smokers, ART-naïve participants, NNRTIs users, participants with shorter duration of diagnosed infection and across the spectrum of HIV severity. Substantial heterogeneities across and within criteria were not fully explained by major study characteristics, while evidence of publication bias was marginal. CONCLUSIONS: The similar range of MS prevalence in the HIV-infected and general populations highlights the common drivers of this condition. Thus, cardio-metabolic assessments need to be routinely included in the holistic management of the HIV-infected individual. Management strategies recommended for MS in the general population will likely provide similar benefits in the HIV-infected. DA - 2016 DB - OpenUCT DO - 10.1371/journal.pone.0150970 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2016 T1 - A meta-analysis of the Metabolic Syndrome prevalence in the global HIV-infected population TI - A meta-analysis of the Metabolic Syndrome prevalence in the global HIV-infected population UR - http://hdl.handle.net/11427/18859 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0150970en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/18859
dc.identifier.vancouvercitationNguyen KA, Peer N, Mills EJ, Kengne AP. A meta-analysis of the Metabolic Syndrome prevalence in the global HIV-infected population. PLoS One. 2016; http://hdl.handle.net/11427/18859.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis 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.en_ZA
dc.rights.holder© 2016 Nguyen et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherMetabolic disordersen_ZA
dc.subject.otherAntiretroviral therapyen_ZA
dc.subject.otherHIV diagnosis and managementen_ZA
dc.subject.otherHIV infectionsen_ZA
dc.subject.otherDatabase searchingen_ZA
dc.subject.otherDiagnostic medicineen_ZA
dc.subject.otherItalyen_ZA
dc.subject.otherMeta-analysisen_ZA
dc.titleA meta-analysis of the Metabolic Syndrome prevalence in the global HIV-infected populationen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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