Prevalence and risk factors of metabolic syndrome in HIV-infected adults at three urban clinics in a post-conflict setting, eastern Democratic Republic of the Congo

ObjectiveTo determine the prevalence of and risk factors for metabolic syndrome (MS) in HIV-infected adults at three urban clinics in Bukavu, Democratic Republic of the Congo. DesignCross-sectional study. MethodsFrom July to September 2016, baseline socio-demographics, risk factors and clinical characteristics were collected using a structured questionnaire or extracted from medical records. Fasting blood sugar and lipids were measured. MS was defined per the National Cholesterol Education Program (NCEP) Adult Treatment PanelIII (ATP III) and the International Diabetes Federation (IDF) criteria. Adjusted odds ratio (OR) was generated through multivariate logistic regression models. ResultsOf 495 participants, 356 (72%) were women and 474 (95.8%) were receiving antiretroviral therapy (ART). The median age (years) [interquartile range (IQR)] was 43 [36-51]. The overall prevalence of MS per NECP/ATP III and IDF criteria was 27% [95% CI: 20-35%] or 30% [95% CI: 23-38%], respectively. In a multivariate logistic regression, low physical activity (OR 2.47, 95% CI: 1.40-4.36); daily exposure to biomass fuel smoke (BMF) for more than 2h (OR 2.18, 95% CI: 1.01-4.68); protease inhibitor containing ART (OR: 2.96, 95% CI: 1.07-8.18); and stavudine-containing ART regimen (OR: 2.57, 95% CI: 1.11-5.93) were independently associated with MS. ConclusionsMS was highly prevalent in this hospital-based study population. Beside known traditional risk factors and contribution of specific ART regimens to MS, daily exposure to BMF is new and of specific concern, necessitating targeted urgent prevention and management interventions. ObjectifDeterminer la prevalence et les facteurs de risque pour le syndrome metabolique (SM) chez les adultes infectes par le VIH dans trois cliniques urbaines a Bukavu, en Republique Democratique du Congo. ConceptEtude transversale. MethodesDe juillet a septembre 2016, les donnees sociodemographiques de base, les facteurs de risque et les caracteristiques cliniques ont ete recueillis a l'aide d'un questionnaire structure ou extraits de dossiers medicaux. La glycemie a jeun et les lipides ont ete mesures. Le SM a ete defini selon les criteres du National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) et de l'International Diabetes Federation (IDF). L'odds ratio ajuste (OR) a ete genere grace a des modeles de regression logistique multivariee. ResultatsSur 495 participants, 356 (72%) etaient des femmes et 474 (95,8%) recevaient un traitement antiretroviral (ART). L'age median [intervalle interquartile (IQR)] etait de 43 [36-51] ans. La prevalence globale du SM selon les criteres du NECP/ATP III et de l'IDF etait respectivement de 27% [IC95%: 20-35] et de 30% [IC95%: 23-38]. Dans une regression logistique multivariee, la faible activite physique (OR: 2,47; IC95%: 1,40-4,36); l'exposition quotidienne de plus de deux heures a la pollution de l'air domestique provenant des fumees de biomasse (OR: 2,18; IC95%: 1,01-4,68), un regime ART contenant un inhibiteur de protease (OR: 2,96; IC95%: 1,07-8,18) et un regime ART contenant du stavudine (OR: 2,57; IC95%: 1,11-5,93) etaient independamment associes au SM. ConclusionsLa prevalence du SM etait elevee dans cette population d'etude hospitaliere. Outre les facteurs de risque traditionnels connus et la contribution de regimes ART specifiques au SM, l'exposition quotidienne a la pollution de l'air domestique avec les fumees de cuisine est nouvelle et particulierement preoccupante, necessitant des interventions de prevention et de prise en charge ciblees et urgentes.