Impact of First-Line Highly Active Antiretroviral Therapy on Metabolic Syndrome: Predictors and Comparative Analysis

Abstract

Even though highly active antiretroviral therapy (HAART) is successful in decreasing HIV-related illness and death, concerns about metabolic syndrome (MetS) are increasing. However, there is limited evidence on the predictors of MetS among adults undergoing first-line HAART regimens in Malaysia. This study aimed to compare the MetS components between first-line HAART regimens containing integrase strand transfer inhibitor (INSTI) and non-INSTI regimens at baseline and 12-month follow-up. Additionally, it aimed to identify predictors of MetS among HIV patients on first-line HAART. This prospective cohort study included adults diagnosed with HIV from January 2023 till April 2023 and receiving first-line HAART for a minimum of 6 months, undergoing follow-up at Hospital Sungai Buloh, Malaysia. Data from 210 patients, mostly males (91.9%) and Malays (47.1%), were analyzed. Significant mean differences in MetS components were observed between patients receiving INSTI and non-INSTI regimens. Multivariate binary logistic regression analysis identified depressive disorders, non-INSTI HAART regimens, and age as significant predictors of MetS among HIV patients. The incidence of MetS was considerable among the study population, highlighting the significance of routinely monitoring patients' clinical and laboratory data and promoting health education to effectively manage and avoid HIV patients' metabolic illnesses.