Perbandingan Kejadian Sindrom Metabolik pada Orang dengan HIV/AIDS dengan Kadar Virus Tidak Terdeteksi yang Mengonsumsi Antiretroviral Berbasis Dolutegravir dan Antiretroviral Berbasis Efavirenz

Abstract

Background: Metabolic syndrome is a condition consisting of central obesity, elevated triglycerides, decreased HDL, hypertension, and hyperglycaemia, which increase the risk of cardiovascular disease and type 2 diabetes mellitus. Long-term use of antiretroviral therapy (ART) such as dolutegravir and efavirenz in people living with HIV/AIDS (PLWHA), is suspected to contribute to an increased incidence of metabolic syndrome. Objective: To determine the difference in the incidence of metabolic syndrome between PLWHA with undetectable viral loads who are using dolutegravir-based and efavirenz-based ART. Methods: A cross-sectional design study conducted from April to December 2024 at the PUSYANSUS Clinic, Haji Adam Malik Hospital, Medan. Samples were obtained through consecutive sampling, There were 118 PLWHA met the inclusion criteria, consisting of 40 individuals on dolutegravir and 78 individuals on efavirenz. Data were collected through interviews, questionnaires, physical examinations, and blood laboratory tests. Results: Among a total of 118 PLWHA, predominantly of reproductive age, metabolic syndrome was most indicated by hyperglycemia. No significant difference was found between the use of dolutegravir and efavirenz in terms of the overall incidence of metabolic syndrome. However, bivariate analysis showed that dolutegravir use tended to increase the risk of obesity and decrease HDL level, while efavirenz use was more associated with elevated blood pressure. Conclusion: No significant difference between dolutegravir and efavirenz concerning the incidence of metabolic syndrome in PLWHA with undetectable viral loads. However, each regimen shows a tendency toward specific metabolic symptoms. Keywords: Metabolic syndrome, HIV/AIDS, antiretroviral, dolutegravir, efavirenz