Metabolic syndrome, cardiovascular disease and type 2 diabetes mellitus after initiation of antiretroviral therapy in HIV infection
Metabolic syndrome (MS) identifies individuals at risk of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Little is known about MS and its consequences following initiation of antiretroviral therapy (ART). HIV-infected adults (881) initiating ART were evaluated for prevalence and i...
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| Veröffentlicht in: | AIDS (London) 2007-11, Vol.21 (18), p.2445-2453 |
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| creator | WAND, Handan CALMY, Alexandra CAREY, Dianne L SAMARAS, Katherine CARR, Andrew LAW, Matthew G COOPER, David A EMERY, Sean |
| description | Metabolic syndrome (MS) identifies individuals at risk of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Little is known about MS and its consequences following initiation of antiretroviral therapy (ART).
HIV-infected adults (881) initiating ART were evaluated for prevalence and incidence of MS and subsequent diagnosis of CVD and T2DM over a 3-year period. MS was defined by criteria of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Third Report; ATP-III) or of the International Diabetes Federation (IDF).
The prevalence of baseline MS was 8.5% and 7.8% (ATP-III and IDF, respectively). During follow-up, 234 (12/100 patient-years) (ATP-III) and 178 (8/100 patient-years) (IDF) progressed to MS. MS at baseline had a borderline association with increased risk of CVD [ATP-III: hazard ratio (HR), 2.56; 95% confidence interval (CI), 0.86-7.60; P = 0.095; IDF: HR, 2.89; 95% CI, 0.98-8.63; P = 0.058] and was significantly associated with an increased risk of T2DM (ATP-III: HR, 4.34; 95% CI, 1.83-10.25; P = 0.001; IDF: HR, 3.33; 95% CI, 1.35-8.17; P = 0.009). Incident MS was significantly associated with an increased risk of both CVD (ATP-III: HR, 2.73; 95% CI, 1.07-6.96; P = 0.036; IDF: HR, 3.05; 95% CI, 1.20-7.75; P = 0.019) and T2DM (ATP-III: HR, 4.89; 95% CI, 2.22-10.78; P < 0.0001; IDF: HR, 4.84; 95% CI, 2.20-10.64; P < 0.0001).
Substantial progression to MS occurs within 3 years following initiation of ART. Since baseline and incident MS identifies individuals at risk for subsequent CVD and T2DM, it warrants evaluation in patients commencing ART. |
| doi_str_mv | 10.1097/qad.0b013e3282efad32 |
| format | Article |
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HIV-infected adults (881) initiating ART were evaluated for prevalence and incidence of MS and subsequent diagnosis of CVD and T2DM over a 3-year period. MS was defined by criteria of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Third Report; ATP-III) or of the International Diabetes Federation (IDF).
The prevalence of baseline MS was 8.5% and 7.8% (ATP-III and IDF, respectively). During follow-up, 234 (12/100 patient-years) (ATP-III) and 178 (8/100 patient-years) (IDF) progressed to MS. MS at baseline had a borderline association with increased risk of CVD [ATP-III: hazard ratio (HR), 2.56; 95% confidence interval (CI), 0.86-7.60; P = 0.095; IDF: HR, 2.89; 95% CI, 0.98-8.63; P = 0.058] and was significantly associated with an increased risk of T2DM (ATP-III: HR, 4.34; 95% CI, 1.83-10.25; P = 0.001; IDF: HR, 3.33; 95% CI, 1.35-8.17; P = 0.009). Incident MS was significantly associated with an increased risk of both CVD (ATP-III: HR, 2.73; 95% CI, 1.07-6.96; P = 0.036; IDF: HR, 3.05; 95% CI, 1.20-7.75; P = 0.019) and T2DM (ATP-III: HR, 4.89; 95% CI, 2.22-10.78; P < 0.0001; IDF: HR, 4.84; 95% CI, 2.20-10.64; P < 0.0001).
Substantial progression to MS occurs within 3 years following initiation of ART. Since baseline and incident MS identifies individuals at risk for subsequent CVD and T2DM, it warrants evaluation in patients commencing ART.</description><identifier>ISSN: 0269-9370</identifier><identifier>EISSN: 1473-5571</identifier><identifier>DOI: 10.1097/qad.0b013e3282efad32</identifier><identifier>PMID: 18025881</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Anthropometry ; Anti-HIV Agents - adverse effects ; Anti-HIV Agents - therapeutic use ; Antiretroviral Therapy, Highly Active - adverse effects ; Antiretroviral Therapy, Highly Active - methods ; Benzoxazines - adverse effects ; Biological and medical sciences ; Body Constitution ; Cardiovascular Diseases - chemically induced ; Diabetes Mellitus, Type 2 - chemically induced ; Diabetes. Impaired glucose tolerance ; Disease Progression ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Epidemiologic Methods ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Female ; HIV Infections - drug therapy ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Infectious diseases ; Male ; Medical sciences ; Metabolic diseases ; Metabolic Syndrome - chemically induced ; Middle Aged ; Miscellaneous ; Nelfinavir - adverse effects ; Other metabolic disorders ; Reverse Transcriptase Inhibitors - adverse effects ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids</subject><ispartof>AIDS (London), 2007-11, Vol.21 (18), p.2445-2453</ispartof><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c478t-bdfecd6ded55eec7258a9bca37b806f730597b2ed7fcc13bbec09ed3ce8eb6843</citedby><cites>FETCH-LOGICAL-c478t-bdfecd6ded55eec7258a9bca37b806f730597b2ed7fcc13bbec09ed3ce8eb6843</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19942178$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18025881$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>WAND, Handan</creatorcontrib><creatorcontrib>CALMY, Alexandra</creatorcontrib><creatorcontrib>CAREY, Dianne L</creatorcontrib><creatorcontrib>SAMARAS, Katherine</creatorcontrib><creatorcontrib>CARR, Andrew</creatorcontrib><creatorcontrib>LAW, Matthew G</creatorcontrib><creatorcontrib>COOPER, David A</creatorcontrib><creatorcontrib>EMERY, Sean</creatorcontrib><creatorcontrib>INITIO Trial International Coordinating Committee</creatorcontrib><title>Metabolic syndrome, cardiovascular disease and type 2 diabetes mellitus after initiation of antiretroviral therapy in HIV infection</title><title>AIDS (London)</title><addtitle>AIDS</addtitle><description>Metabolic syndrome (MS) identifies individuals at risk of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Little is known about MS and its consequences following initiation of antiretroviral therapy (ART).
HIV-infected adults (881) initiating ART were evaluated for prevalence and incidence of MS and subsequent diagnosis of CVD and T2DM over a 3-year period. MS was defined by criteria of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Third Report; ATP-III) or of the International Diabetes Federation (IDF).
The prevalence of baseline MS was 8.5% and 7.8% (ATP-III and IDF, respectively). During follow-up, 234 (12/100 patient-years) (ATP-III) and 178 (8/100 patient-years) (IDF) progressed to MS. MS at baseline had a borderline association with increased risk of CVD [ATP-III: hazard ratio (HR), 2.56; 95% confidence interval (CI), 0.86-7.60; P = 0.095; IDF: HR, 2.89; 95% CI, 0.98-8.63; P = 0.058] and was significantly associated with an increased risk of T2DM (ATP-III: HR, 4.34; 95% CI, 1.83-10.25; P = 0.001; IDF: HR, 3.33; 95% CI, 1.35-8.17; P = 0.009). Incident MS was significantly associated with an increased risk of both CVD (ATP-III: HR, 2.73; 95% CI, 1.07-6.96; P = 0.036; IDF: HR, 3.05; 95% CI, 1.20-7.75; P = 0.019) and T2DM (ATP-III: HR, 4.89; 95% CI, 2.22-10.78; P < 0.0001; IDF: HR, 4.84; 95% CI, 2.20-10.64; P < 0.0001).
Substantial progression to MS occurs within 3 years following initiation of ART. Since baseline and incident MS identifies individuals at risk for subsequent CVD and T2DM, it warrants evaluation in patients commencing ART.</description><subject>Adult</subject><subject>Anthropometry</subject><subject>Anti-HIV Agents - adverse effects</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antiretroviral Therapy, Highly Active - adverse effects</subject><subject>Antiretroviral Therapy, Highly Active - methods</subject><subject>Benzoxazines - adverse effects</subject><subject>Biological and medical sciences</subject><subject>Body Constitution</subject><subject>Cardiovascular Diseases - chemically induced</subject><subject>Diabetes Mellitus, Type 2 - chemically induced</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Disease Progression</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Epidemiologic Methods</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Female</subject><subject>HIV Infections - drug therapy</subject><subject>Human immunodeficiency virus</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metabolic diseases</subject><subject>Metabolic Syndrome - chemically induced</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Nelfinavir - adverse effects</subject><subject>Other metabolic disorders</subject><subject>Reverse Transcriptase Inhibitors - adverse effects</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><issn>0269-9370</issn><issn>1473-5571</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkEtLJDEUhcPgMLaPfzBINs7KcvKo6qSW4jwUHAZB3RY3yQ0Tqaq0SUrotX_ciA3CrA5cvnPgfoR85eycs159fwJ3zgzjEqXQAj04KT6RFW-VbLpO8T2yYmLdN71UbJ8c5PzIGOuY1l_IPtdMdFrzFXn5gwVMHIOleTu7FCc8oxaSC_EZsl1GSNSFjJCRwuxo2W6QinoCgwUznXAcQ1kyBV8w0TCHEqCEONPoa6GEhCXF55BgpOUfJthsK0Svrh9qeLRv6BH57GHMeLzLQ3L_6-fd5VVz8_f39eXFTWNbpUtjXOXd2qHrOkSr6gfQGwtSGc3WXknW9coIdMpby6UxaFmPTlrUaNa6lYfk2_vuJsWnBXMZppBtfQBmjEseBGdtK6WqYPsO2hRzTuiHTQoTpO3A2fAmf7i9-DH8L7_WTnb7i5nQfZR2titwugOqWhh9gtmG_MH1fSu40vIVX4uThA</recordid><startdate>20071130</startdate><enddate>20071130</enddate><creator>WAND, Handan</creator><creator>CALMY, Alexandra</creator><creator>CAREY, Dianne L</creator><creator>SAMARAS, Katherine</creator><creator>CARR, Andrew</creator><creator>LAW, Matthew G</creator><creator>COOPER, David A</creator><creator>EMERY, Sean</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U1</scope><scope>7U2</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope></search><sort><creationdate>20071130</creationdate><title>Metabolic syndrome, cardiovascular disease and type 2 diabetes mellitus after initiation of antiretroviral therapy in HIV infection</title><author>WAND, Handan ; CALMY, Alexandra ; CAREY, Dianne L ; SAMARAS, Katherine ; CARR, Andrew ; LAW, Matthew G ; COOPER, David A ; EMERY, Sean</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c478t-bdfecd6ded55eec7258a9bca37b806f730597b2ed7fcc13bbec09ed3ce8eb6843</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Anthropometry</topic><topic>Anti-HIV Agents - adverse effects</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antiretroviral Therapy, Highly Active - adverse effects</topic><topic>Antiretroviral Therapy, Highly Active - methods</topic><topic>Benzoxazines - adverse effects</topic><topic>Biological and medical sciences</topic><topic>Body Constitution</topic><topic>Cardiovascular Diseases - chemically induced</topic><topic>Diabetes Mellitus, Type 2 - chemically induced</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Disease Progression</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Epidemiologic Methods</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Female</topic><topic>HIV Infections - drug therapy</topic><topic>Human immunodeficiency virus</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metabolic diseases</topic><topic>Metabolic Syndrome - chemically induced</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Nelfinavir - adverse effects</topic><topic>Other metabolic disorders</topic><topic>Reverse Transcriptase Inhibitors - adverse effects</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>WAND, Handan</creatorcontrib><creatorcontrib>CALMY, Alexandra</creatorcontrib><creatorcontrib>CAREY, Dianne L</creatorcontrib><creatorcontrib>SAMARAS, Katherine</creatorcontrib><creatorcontrib>CARR, Andrew</creatorcontrib><creatorcontrib>LAW, Matthew G</creatorcontrib><creatorcontrib>COOPER, David A</creatorcontrib><creatorcontrib>EMERY, Sean</creatorcontrib><creatorcontrib>INITIO Trial International Coordinating Committee</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>AIDS (London)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>WAND, Handan</au><au>CALMY, Alexandra</au><au>CAREY, Dianne L</au><au>SAMARAS, Katherine</au><au>CARR, Andrew</au><au>LAW, Matthew G</au><au>COOPER, David A</au><au>EMERY, Sean</au><aucorp>INITIO Trial International Coordinating Committee</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Metabolic syndrome, cardiovascular disease and type 2 diabetes mellitus after initiation of antiretroviral therapy in HIV infection</atitle><jtitle>AIDS (London)</jtitle><addtitle>AIDS</addtitle><date>2007-11-30</date><risdate>2007</risdate><volume>21</volume><issue>18</issue><spage>2445</spage><epage>2453</epage><pages>2445-2453</pages><issn>0269-9370</issn><eissn>1473-5571</eissn><abstract>Metabolic syndrome (MS) identifies individuals at risk of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Little is known about MS and its consequences following initiation of antiretroviral therapy (ART).
HIV-infected adults (881) initiating ART were evaluated for prevalence and incidence of MS and subsequent diagnosis of CVD and T2DM over a 3-year period. MS was defined by criteria of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Third Report; ATP-III) or of the International Diabetes Federation (IDF).
The prevalence of baseline MS was 8.5% and 7.8% (ATP-III and IDF, respectively). During follow-up, 234 (12/100 patient-years) (ATP-III) and 178 (8/100 patient-years) (IDF) progressed to MS. MS at baseline had a borderline association with increased risk of CVD [ATP-III: hazard ratio (HR), 2.56; 95% confidence interval (CI), 0.86-7.60; P = 0.095; IDF: HR, 2.89; 95% CI, 0.98-8.63; P = 0.058] and was significantly associated with an increased risk of T2DM (ATP-III: HR, 4.34; 95% CI, 1.83-10.25; P = 0.001; IDF: HR, 3.33; 95% CI, 1.35-8.17; P = 0.009). Incident MS was significantly associated with an increased risk of both CVD (ATP-III: HR, 2.73; 95% CI, 1.07-6.96; P = 0.036; IDF: HR, 3.05; 95% CI, 1.20-7.75; P = 0.019) and T2DM (ATP-III: HR, 4.89; 95% CI, 2.22-10.78; P < 0.0001; IDF: HR, 4.84; 95% CI, 2.20-10.64; P < 0.0001).
Substantial progression to MS occurs within 3 years following initiation of ART. Since baseline and incident MS identifies individuals at risk for subsequent CVD and T2DM, it warrants evaluation in patients commencing ART.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>18025881</pmid><doi>10.1097/qad.0b013e3282efad32</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | AIDS (London), 2007-11, Vol.21 (18), p.2445-2453 |
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| source | Journals@Ovid Ovid Autoload; MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adult Anthropometry Anti-HIV Agents - adverse effects Anti-HIV Agents - therapeutic use Antiretroviral Therapy, Highly Active - adverse effects Antiretroviral Therapy, Highly Active - methods Benzoxazines - adverse effects Biological and medical sciences Body Constitution Cardiovascular Diseases - chemically induced Diabetes Mellitus, Type 2 - chemically induced Diabetes. Impaired glucose tolerance Disease Progression Endocrine pancreas. Apud cells (diseases) Endocrinopathies Epidemiologic Methods Etiopathogenesis. Screening. Investigations. Target tissue resistance Female HIV Infections - drug therapy Human immunodeficiency virus Human viral diseases Humans Infectious diseases Male Medical sciences Metabolic diseases Metabolic Syndrome - chemically induced Middle Aged Miscellaneous Nelfinavir - adverse effects Other metabolic disorders Reverse Transcriptase Inhibitors - adverse effects Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids |
| title | Metabolic syndrome, cardiovascular disease and type 2 diabetes mellitus after initiation of antiretroviral therapy in HIV infection |
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