A large body of research has shown a link between combination antiretroviral therapy and various metabolic complications, though the exact association and underlying mechanisms are not yet fully understood.

In the November 30, 2007 issue of AIDS, researchers with the international INITIO trial reported data on the prevalence and incidence of metabolic syndrome in 881 HIV positive adults starting HAART, as well as subsequent diagnosis of cardiovascular disease and type 2 diabetes mellitus over a 3-year period.

Metabolic syndrome was defined by criteria of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP-III) or the International Diabetes Federation (IDF).

Results

Conclusion

“Substantial progression to metabolic syndrome occurs within 3 years following initiation of antiretroviral therapy,” the authors concluded. “Since baseline and incident metabolic syndrome identifies individuals at risk for subsequent cardiovascular disease and type 2 diabetes mellitus, it warrants evaluation in patients commencing antiretroviral therapy.”

National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Australia; St Vincent’s Hospital, Australia; Garvan Institute for Medical Research, Sydney, Australia.

11/27/07

Reference
H Wand, A Calmy, DL Carey, and others (INITIO Trial International Coordinating Committee). Metabolic syndrome, cardiovascular disease and type 2 diabetes mellitus after initiation of antiretroviral therapy in HIV infection. AIDS 21(18): 2445-2453. November 30, 2007.