Prevalence of the Metabolic Syn­drome in the HIV-infected Population

Different studies evaluated the prevalence of the MetS in HIV-infected patients accord­ing to the two most used definitions in the general population.

North American populations with elevated body mass index:

Mondy et al.

European Populations:

Bonfanti et al. [5] in the Italian population found a prevalence of 22% compared to 15.8% in the general population (PAMELA cohort). In the Spanish population, Estrada et al. [6] reported a prevalence of 15.8% in HIV-infected subjects compared to 3.2% in the general population with the same BMI (23 kg/m²). In the APROCO-COPILOTE French cohort, we found a prevalence of 15-20% according to the period of the study, which is much more than that of the general population, inasmuch as the mean BMI was low around 22-23 kg/m². We can conclude that for European studies, the prevalence of MetS is increased in HIV- infected patients compared to the general population.

Prevalence According to IDF definition

Generally, the prevalence is lower when using this definition because of the neces­sary criteria of the abdominal perimeter. This element is uncommon in HIV-infected patients with a lipodystrophic syndrome. Samaras et al. [7], in an international cohort, reported a near similarly prevalence of 18% (ATP III-NCEP) and 14% (IDF) according to the two definitions. However, in the APROCO-COPILOTE cohort, the prevalence was 5-7% according to the peri­od of the study, much lower that the preva­lence identified by the ATP definition.

In HIV-infected patients, the most fre­quent criteria of the metabolic syndrome are elevated triglycerides and low HDL. Increased abdominal girth is rarely found, whereas in the general population, this cri­terion is predominant.