The growing burden of noncommunicable disease among persons living with HIV in Zimbabwe

Smit, Mikaëla; Olney, Jack; Ford, Nathan; Vitória, Marco; Gregson, Simon; Vassall, Anna; Hallett, Timothy B.

doi:10.1097/qad.0000000000001754

Cited by 68 publications

(68 citation statements)

References 22 publications

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“…In addition, the evidence from high‐income countries cannot easily be extrapolated to sub‐Saharan Africa because the epidemic in high‐income countries is largely restricted to key populations who likely differ in important ways from the general population in sub‐Saharan Africa. Several studies have investigated the association between HIV and NCDs in individual African countries , but were limited to only certain regions of single countries using short time spans. One systematic review and meta‐analysis of the association between ART use and hypertension and diabetes mellitus in sub‐Saharan Africa , based on 20 cross‐sectional studies, found that ART is associated with dyslipidaemia, but not with hypertension and diabetes.…”

Section: Introductionmentioning

confidence: 99%

HIV, antiretroviral therapy and non‐communicable diseases in sub‐Saharan Africa: empirical evidence from 44 countries over the period 2000 to 2016

et al. 2019

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Introduction The HIV‐infected population is growing due to the increased accessibility of antiretroviral therapy (ART) that extends the lifespan of people living with HIV (PLHIV). We aimed to assess whether national HIV prevalence and ART use are associated with an increased prevalence of cardiovascular risk factors. Methods Using country‐level data, we analysed the effect of HIV prevalence and use of ART on cardiovascular risk factors in 44 countries in sub‐Saharan Africa between 2000 and 2016. We used fixed‐effects estimation to quantify the effect of HIV and ART on the prevalence of diabetes, mean body mass index, the prevalence of overweight, obesity and hypertension, and mean systolic blood pressure. The models were adjusted for calendar time, the age structure of the population, income and education. Results Diabetes prevalence among PLHIV was 5.8 percentage points higher (95% confidence interval (CI) 1.8 pp to 9.8 pp) compared to individuals without HIV. People receiving ART had a 4.6 percentage point higher prevalence (95% CI 2.6 pp to 6.6 pp). The prevalence of obesity was increased by 14.7 percentage points (95% CI 2.5 pp to 26.9 pp) for PLHIV. Receiving ART was associated with an increased obesity prevalence by 14.0 percentage points (95% CI 4.8 pp to 23.2 pp), whereas it had no significant association with the prevalence of overweight. The population aged 40 to 59 had a significantly higher prevalence of diabetes, overweight and obesity. HIV prevalence and ART use had no significant association with the prevalence of hypertension. Conclusions An ageing HIV‐infected population on ART is associated with a significant increase in the prevalence of diabetes and obesity in sub‐Saharan Africa. The increasing prevalence of these cardiovascular risk factors emphasizes the need for comprehensive healthcare programmes that screen and treat both HIV and non‐communicable diseases to decrease the associated morbidity and mortality rates.

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Section: Introductionmentioning

confidence: 99%

HIV, antiretroviral therapy and non‐communicable diseases in sub‐Saharan Africa: empirical evidence from 44 countries over the period 2000 to 2016

et al. 2019

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“…[30] As the life expectancy of HIV-positive individuals continues to increase, it is important to monitor non-communicable comorbidities such as CVD, hypertension, diabetes, chronic obstructive pulmonary disease, kidney disease and cancer, owing to the increased risk of development at younger ages than is typical in HIV-negative patients. [31][32][33][34][35][36] While these differences were not found in our study population, we suspect that this is because the ED patients in this study may have represented a younger HIV-positive cohort.…”

Section: Researchmentioning

confidence: 99%

“…[4] HIV-positive individuals are predicted to have a 26% increased likelihood of being diagnosed with at least one NCD over time (33% in 2015, 59% in 2035), compared with a 6% increase in likelihood for HIV-negative individuals (14% in 2015, 20% in 2035). [5] In addition, antiretroviral (ARV) medications are known to have a number of complications that predispose PLWH to developing cardiovascular, neurological, muscular, liver, bone and/or immune system disorders as a result of accumulated drug toxicity. [4,6] Current research on HIV infection and associated comorbidities also points towards an increasingly high baseline prevalence of NCDs and other comorbidities in specific populations of interest.…”

Section: Researchmentioning

confidence: 99%

Impact of endemic HIV on emergency care service delivery in South Africa

et al. 2020

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“…Recent studies have documented the substantial burden of depression in resource-limited settings, which can result in not only significant disability, but also premature mortality [2]. Depression is often a co-morbid condition with other chronic illnesses, such as cancer, diabetes, and HIV [3][4][5]. In a meta-analysis of ten studies, people living with HIV experienced a twofold increase in risk of major depressive disorder (MDD) compared to those who were HIV-negative [6].…”

Section: Introductionmentioning

confidence: 99%

Healthy Options: study protocol and baseline characteristics for a cluster randomized controlled trial of group psychotherapy for perinatal women living with HIV and depression in Tanzania

et al. 2020

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Background: Perinatal women accessing prevention of mother-to-child transmission of HIV (PMTCT) services are at an increased risk of depression; however, in Tanzania there is limited access to services provided by mental health professionals. This paper presents a protocol and baseline characteristics for a study evaluating a psychosocial support group intervention facilitated by lay community-based health workers (CBHWs) for perinatal women living with HIV and depression in Dar es Salaam.Methods: A cluster randomized controlled trial (RCT) is conducted comparing: 1) a psychosocial support group intervention; and 2) improved standard of mental health care. The study is implemented in reproductive and child health (RCH) centers providing PMTCT services. Baseline characteristics are presented by comparing sociodemographic characteristics and primary as well as secondary outcomes for the trial for intervention and control groups. The trial is registered under clinicaltrials.gov (NCT02039973).Results: Among 742 women enrolled, baseline characteristics were comparable for intervention and control groups, although more women in the control group had completed secondary school (25.2% versus 18.2%). Overall, findings suggest that the population is highly vulnerable with over 45% demonstrating food insecurity and 17% reporting intimate partner violence in the past 6 months. Conclusions: Baseline characteristics for the cluster RCT were comparable for intervention and control groups. The trial will examine the effectiveness of a psychosocial support group intervention for the treatment of depression among women living with HIV accessing PMTCT services. A reduction in the burden of depression in this vulnerable population has implications in the short-term for improved HIV-related outcomes and for potential long-term effects on child growth and development.Trial registration: The trial is registered under clinicaltrials.gov (NCT02039973).

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The growing burden of noncommunicable disease among persons living with HIV in Zimbabwe

Abstract: Supplemental Digital Content is available in the text

Cited by 68 publications

References 22 publications

HIV, antiretroviral therapy and non‐communicable diseases in sub‐Saharan Africa: empirical evidence from 44 countries over the period 2000 to 2016

HIV, antiretroviral therapy and non‐communicable diseases in sub‐Saharan Africa: empirical evidence from 44 countries over the period 2000 to 2016

Impact of endemic HIV on emergency care service delivery in South Africa

Healthy Options: study protocol and baseline characteristics for a cluster randomized controlled trial of group psychotherapy for perinatal women living with HIV and depression in Tanzania

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