Prevalência da síndrome metabólica em pacientes adultos vivendo com HIV em terapia antirretroviral

Abstract

ABSTRACT Introduction: Antiretroviral therapy (HAART) changed the natural history of HIV infection, with a decline in opportunistic infections and a reduction in mortality, however HAART is associated with metabolic changes that can lead to metabolic syndrome (MS), one of the main factors risk factors for cardiovascular disease (CVD). Objective: To investigate the prevalence and factors associated with metabolic syndrome in adults living with HIV / AIDS on ART. Method: This study was divided into two chapters. In the first, it is a study with secondary data through a systematic literature review and meta-analysis with the theme “prevalence of the metabolic syndrome in people living with HIV / AIDS (PLWHA) on ART”. In the second chapter, a cross-sectional epidemiological study was carried out with 265 patients living with HIV / AIDS. The data were collected at the SAE of the municipality of Ponta Grossa - Paraná, in the period from 2018 to 2019. The information was obtained through the application of structured questionnaires, clinical, anthropometric and biochemical tests. The diagnosis of metabolic syndrome took into account the criteria proposed by the National Cholesterol Education Program - Adult Treatment Panel III (NCEP ATP III). Prevalence ratios and their respective 95% confidence intervals and 5% level of statistical significance were estimated. Multivariate analysis was constructed using Poisson regression. Results: Studies from five continents were represented in the systematic review and meta-analysis, most of them in America. The most frequent criterion used in the review was the definition of the NCEP ATPIII. The overall prevalence of MS among PLWHA was 26% regardless of the ART used, comparable to the general prevalence in developed regions. In the epidemiological study there was a predominance of white people, with an average age of 44.3 years, male biological sex, married or in a stable relationship with heterosexual behavior, the most frequent mode of transmission was sexual, with a predominance of income and low education. The prevalence of metabolic syndrome was 32.5% and the factors that were associated with MS were age group 50 to 59 years old (OR = 8.06; 95% CI = 2.42; 26.84) and female biological sex (OR = 1.83; 95% CI = 1.06; 3.15). Conclusion: This systematic review provides an essential overview of the prevalence of MS in the HIV population on ART and to guide future studies. The prevalence of metabolic syndrome and its association with the use of ART found in the epidemiological study reinforce the need to identify individuals and population groups with greater vulnerability to the occurrence of CVD.