Metabolic Syndrome among People Living with HIV on Antiretroviral Therapy at the National Hospital of Niamey, Niger

Abstract

Background: Metabolic syndrome (MetS) is a cluster of interrelated cardiometabolic risk factors, including central obesity, dyslipidaemia, hypertension and hyperglycaemia, that affect an estimated 28% of adults worldwide and predispose them to type 2 diabetes and atherosclerotic cardiovascular disease. People living with HIV (PLHIV) on antiretroviral therapy (ART) are at increased risk of MetS compared with the general population, yet data from Niger remain scarce. Aim: To determine the prevalence of metabolic syndrome and describe its associated epidemiological, clinical, biological and therapeutic factors among PLHIV receiving ART and followed at the National Hospital of Niamey (HNN), Niger. Methodology: This was a descriptive, prospective, cross-sectional study conducted over a 7-month period at the day hospital of the HNN. All consenting HIV-positive adults (≥18 years; no children were included) who had received ART for at least 3 months and met the International Diabetes Federation (IDF, 2005) criteria for MetS were enrolled using exhaustive (consecutive) sampling of all eligible patients seen during the study period; no formal sample-size calculation was performed because of this exhaustive approach. Data were analysed using EpiInfo software, version 7.2.2.6. Results: Of 954 PLHIV seen during 1,380 consultations over the study period, 103 met the IDF criteria for MetS, giving a prevalence of 10.8%. Patients were predominantly female (80.6%), with a mean age of 45.5 ± 8.4 years (range: 26–65 years). Hypertension was present in 39.8%, abdominal obesity in 75.9%, and 39.8% were overweight or obese. HDL hypocholesterolaemia (58.3%), hypertriglyceridaemia (47.6%) and total hypercholesterolaemia (31.1%) were the leading lipid abnormalities. HIV-1 accounted for 99% of infections, and most patients (77.7%) were receiving a two-NRTI plus one-NNRTI regimen. Conclusion: Metabolic syndrome affects roughly one in nine PLHIV receiving ART at the HNN, with a marked female predominance and a high burden of dyslipidaemia and abdominal obesity. These findings support the systematic integration of clinical and biological metabolic screening into routine HIV care in Niger.