{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T11:53:53Z","timestamp":1790769233268,"version":"4.1.0"},"reference-count":53,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T00:00:00Z","timestamp":1622592000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001349","name":"National Medical Research Council","doi-asserted-by":"crossref","award":["MOH-000276"],"award-info":[{"award-number":["MOH-000276"]}],"id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>While the use of combination antiretroviral therapy (cART) has conferred significant reduction in morbidity and mortality, there are growing concerns about the metabolic complications of antiretroviral regimens in HIV-infected patients. The aim of this study was to estimate the prevalence of metabolic syndrome (MetS) among people living with HIV (PLHIV) in Singapore.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective study using the clinical database maintained by the Clinical HIV Programme at the National Centre for Infectious Diseases, Singapore. Treatment-experienced PLHIV on follow-up during 2015\u20132017 were included. MetS was defined as having three or more of the following five abnormalities: hypertriglyceridemia, HDL hypocholesterolemia, hypertension, obesity, and diabetes.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>A total of 2,231 PLHIV were included in this study. 93.9% were men, and the median age at latest follow-up was 48 years. The median duration of HIV infection and duration of exposure to cART was 6.8 years and 5.7 years, respectively. All had been exposed to nucleoside reverse transcriptase inhibitors (NRTIs) as the first line of treatment, 93.9% to non-NRTIs, 28.6% to protease inhibitors (PIs) and 12.8% to integrase strand transfer inhibitors. The most common metabolic abnormality among PLHIV was HDL hypocholesterolemia (60.2%) followed by hypertriglyceridemia (45.5%). Of all the 2,231 individuals, 68.8% had at least one component of MetS. The overall prevalence of MetS was 23.6% (95% confidence interval 21.9%\u201325.4%). Of the 526 with MetS, the most common combination was HDL hypocholesterolemia, hypertriglyceridemia and hypertension (51.0%), followed by HDL hypocholesterolemia, hypertriglyceridemia, hypertension and diabetes (25.1%). Compared with PLHIV without MetS, a significantly higher proportion of those with MetS were ever on protease inhibitors (33.5% vs. 27.1%).<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusion<\/jats:title><jats:p>MetS is common in PLHIV. In view of the progressive aging of HIV-infected population and long-term use of cART, regular monitoring for metabolic abnormalities, surveillance of drug effects and behavioural interventions are needed to optimize management and prevention of metabolic disorders in PLHIV.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0252320","type":"journal-article","created":{"date-parts":[[2021,6,3]],"date-time":"2021-06-03T02:20:15Z","timestamp":1622686815000},"page":"e0252320","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":16,"title":["An observational study of the prevalence of metabolic syndrome in treatment-experienced people living with HIV in Singapore"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0036-255X","authenticated-orcid":true,"given":"Li Wei","family":"Ang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oon Tek","family":"Ng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irving Charles","family":"Boudville","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yee Sin","family":"Leo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen Seong","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,6,2]]},"reference":[{"issue":"4","key":"pone.0252320.ref001","doi-asserted-by":"crossref","first-page":"683","DOI":"10.2337\/diacare.24.4.683","article-title":"Cardiovascular morbidity and mortality associated with the metabolic syndrome","volume":"24","author":"B Isomaa","year":"2001","journal-title":"Diabetes Care"},{"issue":"4","key":"pone.0252320.ref002","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/j.jacc.2006.09.032","article-title":"Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies","volume":"49","author":"AS Gami","year":"2007","journal-title":"J Am Coll Cardiol"},{"issue":"5","key":"pone.0252320.ref003","first-page":"1045","article-title":"Lipids, lipoproteins, triglyceride clearance, and cytokines in human immunodeficiency virus infection and the acquired immunodeficiency syndrome","volume":"74","author":"C Grunfeld","year":"1992","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"pone.0252320.ref004","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1097\/QAI.0b013e318074ef83","article-title":"HIV and metabolic syndrome: a comparison with the general population","volume":"45","author":"P Bonfanti","year":"2007","journal-title":"J Acquir Immune Defic Syndr"},{"key":"pone.0252320.ref005","doi-asserted-by":"crossref","first-page":"2555","DOI":"10.2165\/00003495-200363230-00001","article-title":"Metabolic complications associated with HIV protease inhibitor therapy","volume":"63","author":"D. 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