Table 1.

Patient-specific Factors Contributing to the Development of Metabolic Syndrome in HIV/HCV Co-infection

Risk category	Viral infection	Risk factors
Socioeconomics	HIV/HCV	Low household income High carbohydrate diet Physical inactivity
Substance use	HIV/HCV	Tobacco (increased CVD risk and mortality) Marijuana (increased CVD risk) Cocaine (subclinical coronary atherosclerosis)
Liver disease	HIV	Accelerated natural history of HCV-liver disease Alcoholic fatty liver disease Non-alcoholic fatty liver disease Drug-induced hepatoxicity Opportunistic infections AIDS cholangiopathy
	HCV	Natural history: steatosis >> fibrosis >> cirrhosis Hepatic decompensation Hepatocellular carcinoma
Kidney disease	HIV/HCV	Non-recovered acute kidney injury Hypertension Diabetes mellitus
	HIV	HIV-associated nephropathy Immune-complex mediated glomerulonephritis Thrombotic microangiopathy ART-associated nephrotoxicity
	HCV	Mixed cryoglobulinemia syndrome Membranous nephropathy Polyarteritis nodosa
Cardiovascular comorbidities	HIV/HCV	Dyslipidemia Elevated blood pressure Impaired glucose tolerance Increased waist-to-hip ratio

Abbreviations: ART = antiretroviral therapy; CVD = cardiovascular disease