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Virologic failure and metabolic syndrome in patients with HIV infection

Purpose of the study

The objective of our study was to assess the association between HIV-RNA viral load (HIV-VL) and metabolic syndrome (MS) prevalence in a cohort of HIV patients experienced to ART with lipodystrophy (LD).


This was a cross-sectional observational study that included all consecutive HIV-infected patients evaluated at the metabolic clinic of the University of Modena and Reggio Emilia, Italy, between January 2006 and January 2008 who had received antiretroviral therapy for at least 2 years. Lipodystrophy and metabolic syndrome were defined according to MACS classification and to NCEP-ATP III criteria, respectively.

Summary of results

1,348 patients were analyzed. 850 (63.1%) were males; mean age was 44.8 years (± 7.1). Obesity, defined by body mass index >30, was diagnosed in 78 patients (5.8%). Prevalence of metabolic syndrome was 24.4%. 84.8% of the patients had HIV VL<400 copies/mL. LD was diagnosed in 88.3%: 515 (39.3%) patients had lipoatrophy; 116 (8.9%) had fat accumulation; and 527 (40.2%) had mixed forms. Patients with MS had statistically significant greater value of each diagnostic criteria than those without (Table 1). Higher BMI, lipodystrophy presence, as well as VAT/TAT, trunk fat, total fat and total lean mass were associated with MS diagnosis (Table 1). MS was more prevalent in patients with higher log HIV-VL, PI and NNRTI current use and NNRTI exposure (Table 1). Multivariate logistic regression shown in Table 2 illustrates that log HIV-VL is an independent predictor of metabolic syndrome.

Table 1
Table 2


Our study highlights that HIV-infected patients experiencing virological failure are more at risk to develop MS. It is necessary to obtain virologic suppression to prevent not only AIDS-related opportunistic infections, but also those cardiovascular events and diabetes related to MS presence.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Squillace, N., Zona, S., Orlando, G. et al. Virologic failure and metabolic syndrome in patients with HIV infection. JIAS 11 (Suppl 1), P115 (2008).

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