Noncommunicable diseases among HIV-infected persons in low-income and middle-income countries: a systematic review and meta-analysis.

Journal: AIDS (London, England)

Volume: 32 Suppl 1

Issue: Suppl 1

Year of Publication: 2019

Affiliated Institutions:  Center for Global Health. National Center on Birth Defects & Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia. University of Washington, Department of Psychiatry and Behavioral Sciences and Department of Global Health. National Institute of Diabetes and Digestive and Kidney Diseases. National Cancer Institute. National Heart, Lung, and Blood Institute. Fogarty International Center, National Institutes of Health, Bethesda, Maryland. Purdue University College of Pharmacy, West Lafayette, Indiana, USA. National Institute of Mental Health, National Institutes of Health. Department of Medicine, University of Cape Town, Cape Town, South Africa.

Abstract summary 

To appropriately identify and treat noncommunicable diseases (NCDs) among persons living with HIV (PLHIV) in low-and-middle-income countries (LMICs), it is imperative to understand the burden of NCDs among PLHIV in LMICs and the current management of the diseases.Systematic review and meta-analysis.We examined peer-reviewed literature published between 1 January 2010 and 31 December 2016 to assess currently available evidence regarding HIV and four selected NCDs (cardiovascular disease, cervical cancer, depression, and diabetes) in LMICs with a focus on sub-Saharan Africa. The databases, PubMed/MEDLINE, Cochrane Review, and Scopus, were searched to identify relevant literature. For conditions with adequate data available, pooled estimates for prevalence were generated using random fixed effects models.Six thousand one hundred and forty-three abstracts were reviewed, 377 had potentially relevant prevalence data and 141 were included in the summary; 57 were selected for quantitative analysis. Pooled estimates for NCD prevalence were hypertension 21.2% (95% CI 16.3-27.1), hypercholesterolemia 22.2% (95% CI 14.7-32.1), elevated low-density lipoprotein 23.2% (95% CI 15.2-33.6), hypertriglyceridemia 27.2% (95% CI 20.7-34.8), low high-density lipoprotein 52.3% (95% CI 35.6-62.8), obesity 7.8% (95% CI 4.3-13.9), and depression 24.4% (95% CI 12.5-42.1). Invasive cervical cancer and diabetes prevalence were 1.3-1.7 and 1.3-18%, respectively. Few NCD-HIV integrated programs with screening and management approaches that are contextually appropriate for resource-limited settings exist.Improved data collection and surveillance of NCDs among PLHIV in LMICs are necessary to inform integrated HIV/NCD care models. Although efforts to integrate care exist, further research is needed to optimize the efficacy of these programs.

Authors & Co-authors:  Patel Pragna P Rose Charles E CE Collins Pamela Y PY Nuche-Berenguer Bernardo B Sahasrabuddhe Vikrant V VV Peprah Emmanuel E Vorkoper Susan S Pastakia Sonak D SD Rausch Dianne D Levitt Naomi S NS

Study Outcome 

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Statistics
Citations :  Joint United Nations Programme on HIV/AIDS (UNAIDS). Global AIDS Update 2016. Available at: http://www.unaids.org/en/resources/documents/2016/Global-AIDS-update-2016. [Accessed 20 July 2017]
Authors :  11
Identifiers
Doi : 10.1097/QAD.0000000000001888
SSN : 1473-5571
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Study Design
Cross Sectional Study
Study Approach
Quantitative,Systemic Review
Country of Study
Publication Country
England