Association between high serum alanine aminotransferase to high density lipoprotein cholesterol ratio and metabolic syndrome among people living with HIV on dolutegravir-based ART in South-Western Uganda

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dc.contributor.authorBagenda, Charles Nkubi
dc.contributor.authorNantongo, Carol
dc.contributor.authorMugisa, Michael Junior
dc.contributor.authorAinebyoona, Blendar
dc.contributor.authorOyuru, Amos
dc.contributor.authorNzaramba, Daniel
dc.contributor.authorTumusiime, Jazira
dc.contributor.authorLubwama, Conrad
dc.contributor.authorMusinguzi, Benson
dc.contributor.authorOsuwat, Lawrence Obado
dc.contributor.authorSsenkumba, Brian
dc.contributor.authorOmolo, Ronald Ouma
dc.date.accessioned2026-02-09T10:56:37Z
dc.date.available2026-02-09T10:56:37Z
dc.date.issued2026-02-03
dc.descriptionThis study advances Uganda’s National Development Plan IV by facilitating early detection and prevention of non-communicable diseases (NCDs) among people living with HIV through routine, low-cost clinical markers. This approach strengthens integrated HIV-NCD care delivery and reduces long-term healthcare system expenditures. Furthermore, this research contributes to the Sustainable Development Goals, particularly SDG 3 (good health and well-being), by promoting timely identification of metabolic syndrome and improving long-term health outcomes for individuals receiving antiretroviral therapy.
dc.description.abstractBackground Serum Alanine aminotransferase to High density lipoprotein cholesterol ratio (ALT-to-HDL-C ratio) has been identified as a significant predictor of non-alcoholic fatty liver disease, a hepatic manifestation of metabolic syndrome. This study investigated the association between serum aminotransferases to high-density lipoprotein cholesterol ratios and metabolic syndrome (MetS) among people living with HIV (PLWH) on Dolutegravir (DTG)-based antiretroviral therapy (ART) in South Western Uganda. Methods We conducted a secondary analysis study from June 15, 2025 to August 20, 2025 using a dataset generated from hospital-based cross-sectional study that investigated an association between aspartate aminotransferase to alanine aminotransferase ratio and MetS among 377 PLWH who were on DTG-based ART at Ruhoko Health Centre IV, South Western Uganda. Results The prevalence of MetS was 44.6%(168/377); 95% CI: 39.6 - 49.6 and significantly increased from the lowest to the highest ALT-to-HDL-C ratio tertiles (30.2% vs 47.7% vs 56.1%, p < 0.001). In the adjusted model, higher ALT-to-HDL-C ratio was significantly associated with MetS. Individuals in the second tertile had 2.35-fold higher odds (aOR 2.35, 95% CI: 1.26–4.41, p = 0.008), and those in the third tertile had over fourfold higher odds (aOR 4.65, 95% CI: 2.25–9.61, p < 0.001) of MetS compared to the lowest tertile. ALT-to-HDL-C ratio at an optimal cutoff of 0.33 had a significant ability (AUC=0.820, 95%CI: 0.782 - 0.861) to differentiate between participants with MetS from those without MetS at a sensitivity of 92% and specificity of 54%. Conclusion Higher ALT-to-HDL-C ratio is potentially associated with MetS. Since both ALT and HDL-C are routine measurements in HIV Care, this warrants further studies on the potential of ALT-to-HDL-C ratio as a biomarker for MetS.
dc.description.sponsorshipMbarara University of Science and Technology, Faculty of Medicine
dc.identifier.citationBagenda, C. N., Nantongo, C., Mugisa, M. J., Ainebyoona, B., Oyuru, A., Nzaramba, D., ... & Omolo, R. O. (2026). Association between high serum alanine aminotransferase to high density lipoprotein cholesterol ratio and metabolic syndrome among people living with HIV on dolutegravir-based ART in South-Western Uganda. Journal of the International Association of Providers of AIDS Care (JIAPAC), 25, 23259582261420274.
dc.identifier.issn2325-9582
dc.identifier.urihttps://dir.muni.ac.ug/handle/20.500.12260/912
dc.language.isoen
dc.publisherSage Journals
dc.subjectALT-to-HDL-C ratio
dc.subjectmetabolic syndrome
dc.subjectinsulin resistance
dc.subjectdolutegravir-based ART
dc.titleAssociation between high serum alanine aminotransferase to high density lipoprotein cholesterol ratio and metabolic syndrome among people living with HIV on dolutegravir-based ART in South-Western Uganda
dc.typeArticle

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