Serum IL-6 and hs-CRP as Biomarkers of Metabolic Syndrome in HIV Patients on HAART: A Prospective Cohort Study in Sokoto, Northwestern Nigeria

Background: The highly active antiretroviral therapy (HAART) significantly improves the life expectancy and quality of life of HIV-infected patients but leads to cardiovascular complications and metabolic disorders. Therefore, we aim to determine the utility of IL-6 and high-sensitivity C-reactive protein (hs-CRP) as biomarkers for the development of metabolic syndrome (MetS) among HIV-positive treatment-naïve and HAART-experienced patients. Materials and Methods: We employed a prospective cohort design to evaluate metabolic syndrome development in HAART-naive HIV patients. We enrolled eighty-six participants and followed them up for 24 months, with standardized assessments every six months of parameters including fasting glucose, lipid profiles, and inflammatory markers. MetS was defined using NCEP-ATP III and IDF criteria. To analyze these data, we used Spearman correlation to assess MetS component relationships and logistic regression to evaluate IL-6/hs-CRP predictive capacity. Results: Metabolic correlations differed significantly between treatment-naive and HAART-exposed patients. Among treatment-naive patients with HIV, MetS correlated positively and significantly with triglycerides (TG; p < 0.001) and high-density lipoprotein cholesterol (HDL-C; p < 0.001), as well as positively but insignificantly with high-sensitivity C-reactive protein (hs-CRP; p = 0.078). In contrast, fasting blood glucose (FBS) and IL-6 showed a significant inverse relationship (p<0.001 versus p = 0.012). In HAART-exposed HIV patients, hs-CRP was correlated with metS positively and significantly and IL-6 negatively but non-significantly. However, longitudinal analysis at twelve and twenty-four months post-HAART revealed that only TG and HDL-c show the power to independently and significantly predict MetS. Conclusion: IL-6 and hs-CRP failed to demonstrate predictive accuracy as biomarkers of MetS in HIV patients on HAART.