Background:  HIV-infected persons may be at higher risk for the metabolic syndrome (MetS). Data are lacking on risk for MetS, particularly in HIV⁺ women and minorities, who represent an increasing proportion of the U.S. HIV⁺ population.

Methods:  In 2005, a survey to assess cardiovascular risk was distributed to all patients at our Adult Outpatient HIV Clinic who completed 1 visit within a 6-month period. Patients waist circumference and fasting lipids/glucose were also measured.

Results:  Of the 601 patients who completed the survey, 394(66%) were men, 207(34%) women; 61% were black; 69% were currently on ART; and 10% were ART-naïve. Median waist circumference and body mass index were 87.0 cm and 24.8 for men, 89.0 cm and 28.6 for women (p <0.01). The median CD4 count was 412 cells/mm³; 60% of patients had complete viral suppression (HIV RNA <40 copies/mL); 74% of patients had at least one risk factor for MetS according to the National Cholesterol Education Program criteria; 30% had hypertension; and 26% had an elevated waist circumference. Among 472 patients with fasting lab data, 121 (25.6%, 41 women, 80 men) had MetS. Among MetS factors, hypertension carried the highest risk for MetS, followed by low HDL and waist circumference (OR= 40.3, 1.13, 1.09, respectively, all p <0.001). MetS was also significantly associated with family history of cardiovascular disease/diabetes, white race, older age, years with HIV, high LDL, diabetes, and higher CD4 (all p £0.05). In multivariate analyses, only current CD4 was significant in addition to MetS criteria (p = 0.002). Protease inhibitor use was associated with high triglycerides only. Patients on ART were more likely to be screened for MetS than those not on ART (p <0.01).

Conclusions:  Patients without advanced HIV have a prevalence of MetS similar to that reported for the general U.S. population, regardless of ART status. Traditional risk factors, particularly hypertension, should be main considerations in assessing cardiovascular risk.