Metabolic Syndrome in People Living with HIV in Brazil

Abstract

Metabolic Syndrome (MS) is characterized as a disorder related to central fat deposition and
insulin resistance, and has a highly variable definition in the literature. According to the
National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III), Metabolic
Syndrome represents the combination of at least three components, among the following:
abdominal circumference > 102 cm in men and > 88 cm in women, triglycerides ≥ 150 mg/dL,
HDL cholesterol <40 mg/dL in men and <50 mg/dL in women, blood pressure ≥ 130 mmHg or
≥ 85 mmHg and fasting glucose ≥ 110 mg/dL. Concomitantly, the World Health Organization
defines MS as the combination of factors that can be altered, such as insulin resistance, high
blood pressure, high triglycerides, low HDL cholesterol and central obesity with BMI > 30. It is
known, therefore, that Brazil has more than 700,000 people infected with HIV, and the
number of patients on antiretroviral therapy (ART) in the country has doubled in the last 10
years. Currently, there are more than 300,000 patients using Highly Active Antiretroviral
Therapy (HAART). This new scenario has led to metabolic changes and specific toxicities
associated with the use of this medication. These metabolic changes often meet the criteria
for identifying the presence of metabolic syndrome in people living with HIV.