{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T14:53:25Z","timestamp":1790952805853,"version":"4.1.0"},"reference-count":70,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004417","name":"Global Fund to Fight AIDS, Tuberculosis and Malaria","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004417","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Ghana Health Service"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,4,4]]},"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The use of antiretroviral therapy has been linked to the development of some components of metabolic syndrome (MetS), specifically glucose intolerance, weight gain and defective lipid metabolism. This study determined the relationship between dolutegravir (DTG) and MetS in a cohort of persons living with HIV (PWH) initiating DTG-based regimen in Ghana.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>A 2-year observational prospective study was conducted from September 2020 to August 2022.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Five HIV high-burden facilities providing antiretroviral therapy services at the district and tertiary levels of care in Ghana.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Persons with HIV who were newly enrolled onto DTG.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary and secondary outcome measures<\/jats:title>\n                  <jats:p>Waist circumference, body mass index, blood pressure, fasting blood glucose and lipids were the primary outcomes measured at baseline, 3, 6, 12 and at 18 months follow-up to determine the incidence of MetS. MetS was defined using the Joint Consensus definition that combines the International Diabetes Federation and the National Cholesterol Education Programme Adult Treatment Panel III (ATP III) definitions. The Kaplan-Meier estimator was used to estimate the risk of developing MetS. The Cox proportional hazard model was used in estimating HRs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 3664 PWH screened at baseline, 31.4% (1152\/3664) had MetS. Of the remaining 2512 with no MetS at baseline, there were 960 incident cases of MetS over the 1.5 years follow-up. The estimated MetS incident rate is 384.2 (95% CI: 360.6 to 409.2) per 1000 person-years with a median time to development of MetS at 6 months (IQR; 3\u201312 months). Being female (adjsuted HR, aHR: 1.42, 95% CI: 1.19 to 1.70), age \u226550 years (aHR: 1.30, 95% CI: 1.12 to 1.51), having a comorbidity at baseline (aHR: 1.39, 95% CI: 1.12 to 1.51) and being overweight (aHR: 1.46, 95% CI: 1.25 to 1.71) and obese (aHR: 1.62, 95% CI: 1.36 to 1.93) were associated with higher risk of MetS development.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The incidence of MetS was high among our patients, with elevated fasting blood sugar and elevated blood pressure being the most common developed MetS defining components. HIV programmes should institute targeted interventions at addressing central obesity to reduce the risk of MetS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-097340","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T01:35:22Z","timestamp":1746754522000},"page":"e097340","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Metabolic syndrome among a Ghanaian cohort living with HIV initiated on dolutegravir in a real-world setting: a prospective study"],"prefix":"10.1136","volume":"15","author":[{"given":"Kwasi","family":"Torpey","sequence":"first","affiliation":[{"name":"Department of Population, Family, Reproductive Health, School of Public health, University of Ghana, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8649-4344","authenticated-orcid":false,"given":"Vincent","family":"Ganu","sequence":"additional","affiliation":[{"name":"Department of Medicine, Korle Bu Teaching Hospital, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest","family":"Kenu","sequence":"additional","affiliation":[{"name":"Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Ayisi Addo","sequence":"additional","affiliation":[{"name":"National AIDS &STI Control Programme, Ghana Health Service, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kofi","family":"Agyabeng","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, School of Public Health, University of Ghana, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalene Akos","family":"Odikro","sequence":"additional","affiliation":[{"name":"Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Adu-Gyamfi","sequence":"additional","affiliation":[{"name":"National AIDS &STI Control Programme, Ghana Health Service, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul Gafaru","family":"Mohammed","sequence":"additional","affiliation":[{"name":"National Malaria Elimination Program, Ghana Health Service, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Lartey","sequence":"additional","affiliation":[{"name":"Department of Medicine, Korle Bu Teaching Hospital, Accra, Ghana"},{"name":"Department of Medicine & Therapeutics, University of Ghana Medical School, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"key":"2025101812504110000_15.5.e097340.1","doi-asserted-by":"crossref","DOI":"10.1186\/1741-7015-9-48","article-title":"Metabolic syndrome: definitions and controversies","volume":"9","author":"Kassi","year":"2011","journal-title":"BMC Med"},{"key":"2025101812504110000_15.5.e097340.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2006.01858.x"},{"key":"2025101812504110000_15.5.e097340.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-016602","article-title":"Prevalence of metabolic syndrome, discrete or comorbid diabetes and hypertension in sub-Saharan Africa among people living with HIV versus HIV-negative populations: a systematic review and meta-analysis protocol","volume":"7","author":"Todowede","year":"2017","journal-title":"BMJ Open"},{"key":"2025101812504110000_15.5.e097340.4","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofad241","article-title":"Prevalence of Cardiometabolic Disease Risk Factors in People With HIV Initiating Antiretroviral Therapy at a High-Volume HIV Clinic in Kampala, Uganda","volume":"10","author":"Amutuhaire","year":"2023","journal-title":"Open Forum Infect Dis"},{"key":"2025101812504110000_15.5.e097340.5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0150970","article-title":"A Meta-Analysis of the Metabolic Syndrome Prevalence in the Global HIV-Infected Population","volume":"11","author":"Nguyen","year":"2016","journal-title":"PLoS One"},{"key":"2025101812504110000_15.5.e097340.6","unstructured":"UNAIDS . 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