BACKGROUND: The increased risk of metabolic syndrome (MetS) and its subcomponents among people living with HIV/AIDS, especially in developing countries, is well documented with the global pooled prevalence of the related risk factors in this population. OBJECTIVE: This study aimed to explore the prevalence of MetS among Iranian People living with HIV according to the ATP III and Iranian criteria. METHODS: The cross-sectional study was conducted on consecutive patients who visited THE re-ferral centre for AIDS/HIV between May to December 2023. A total of 130 participants (n=83
63.8% male) were investigated based on the inclusion criteria, which included having a minimum age of 25 and a maximum of 65 years and following a stable ART treatment regimen for at least six months. A Chi-square test was used to determine the relationship between the categorical variables. Uni/Multi-variable linear regression analysis was used to quantify the associations be-tween MetS and HIV by the independent variables. RESULTS: The incidence of MetS according to ATP III and Iranian criteria were 42 (32.3%) and 45 (34.6%), which was higher in older patients (p=0.001) and those with more duration since HIV diagnosis (p=0.02). Around 33.1% and 16.1% were overweight and obese, respectively. Among the components of MetS, the highest prevalence (50.8%) was related to low HDL, and the lowest was related to fasting blood sugar (21.5%). The average body fat mass, protein mass, Soft lean mass, and percentage body fat were 18.54±9.46 kg, 10.91±2.17 kg, 51.31±9.61 kg, and 24.86±10.25% that were higher in MetS group (p<
0.05). CONCLUSION: Our study points out the high prevalence of MetS in an Iranian population living with HIV, especially those suffering from the underlying disease for a longer time. Conducting multi-centric studies with larger sample sizes is needed to confirm our results and determine the most effective measures.