iarjcrIARJCRIARJCR2789-6064https://doi.org/10.47310/iarjcr.2025.v05i02.001Prevalence and Correlates of Metabolic Syndrome and Cardiovascular Risk in HIV-Positive Patients on ART: A Cross-Sectional StudyBackground: With the increasing life expectancy of people living with HIV (PLHIV) due to widespread antiretroviral therapy (ART), non-communicable diseases such as metabolic syndrome (MetS) and cardiovascular abnormalities are emerging as significant health concerns. This study aimed to assess the prevalence and correlates of metabolic syndrome and cardiovascular risk in HIV-positive individuals on long-term ART. Methods: This cross-sectional observational study included 60 HIV-positive patients attending a tertiary care center in Western India from October 2022 to June 2024. Patients on ART for ≥12 months were assessed through clinical history, anthropometry, laboratory investigations, electrocardiography (ECG), and echocardiography (ECHO). Metabolic syndrome was defined as per NCEP ATP III criteria. Associations with ART duration and CD4 count were statistically analyzed. Results: The prevalence of metabolic syndrome was 28.3%. A majority were male (58.3%) and on ART for more than 3 years (76.7%). Obesity (35%) and dyslipidemia were common. Metabolic syndrome was significantly associated with higher CD4 counts (p = 0.04), but not with ART duration (p = 0.19). Cardiovascular abnormalities were frequent, with diastolic dysfunction seen in 40% on ECHO and sinus bradycardia (23.3%) on ECG being the most common findings. Conclusion: A substantial proportion of HIV-positive patients on ART exhibit features of metabolic syndrome and subclinical cardiovascular dysfunction. These findings underscore the need for routine screening and integrated management of cardiometabolic risk in HIV care to prevent long-term morbidity and mortality.