( most one fourth of the NFHL participant...)HIV Treatments Improve Health, but Nutritional Issues Remain,Health

most one fourth of the NFHL participants had metabolic syndrome, although this is lower than the incidence of metabolic syndrome in the population as a whole,” says Jacobson. “Strikingly, 77 percent of people with metabolic syndrome in the NFHL study had the same two defining characteristics, low HDL cholesterol and hypertriglyceridemia.”

“It appears that HIV viral load and metabolic syndrome are associated, as people with both HIV and metabolic syndrome were likely to have a clinically relevant increase in viral load within six months of developing components of metabolic syndrome,” says Gorbach, who is a professor at Tufts University School of Medicine and at the Friedman School of Nutrition Science and Policy at Tufts. “An increased viral load is also linked to a decrease in HDL cholesterol levels, so this may be what drives metabolic syndrome in people with HIV.”

Both HAART and non-HAART users in the NFHL study had a higher incidence of low HDL than the NHANES population. However, only HAART users demonstrated high triglyceride levels, leading the researchers to conclude that certain anti-retroviral therapies may also increase the risk for components of metabolic syndrome.

“We have seen that people with HIV have an increased prevalence of two of the characteristics of metabolic syndrome, components that are also associated with cardiovascular disease (CVD) and diabetes,” says Wanke, a professor at Tufts University School of Medicine. “People with HIV are also living longer due to advances in treatment, and their risk of CVD and diabetes increases with age as it does in the general population. Since people with HIV are already at higher risk for low HDL cholesterol and hypertriglyceridemia, it might be important for health care providers to monitor risk for metabolic syndrome, as these risk factors may increase the likelihood of additional medical complications.”

Using the same NHFL population, Clara Jones, MD, MP
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