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

Pragna Patel, Charles E. Rose, Pamela Y. Collins, Bernardo Nuche-Berenguer, Vikrant V. Sahasrabuddhe, Emmanuel Peprah, Susan Vorkoper, Sonak D. Pastakia, Dianne Rausch, Naomi S. Levitt

Research output: Contribution to journalReview article

Abstract

Objective: 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. Design: Systematic review and meta-analysis. Methods: 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. Results: 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. Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)S5-S20
JournalAIDS
Volume32
DOIs
StatePublished - Jul 1 2018

Fingerprint

Meta-Analysis
HIV
LDL Lipoproteins
Uterine Cervical Neoplasms
Africa South of the Sahara
Hypertriglyceridemia
HDL Lipoproteins
Disease Management
Hypercholesterolemia
PubMed
MEDLINE
Cardiovascular Diseases
Obesity
Databases
Hypertension
Research

Keywords

  • health systems
  • HIV
  • integration
  • low-income and middle-income countries
  • noncommunicable disease

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Noncommunicable diseases among HIV-infected persons in low-income and middle-income countries : A systematic review and meta-analysis. / Patel, Pragna; Rose, Charles E.; Collins, Pamela Y.; Nuche-Berenguer, Bernardo; Sahasrabuddhe, Vikrant V.; Peprah, Emmanuel; Vorkoper, Susan; Pastakia, Sonak D.; Rausch, Dianne; Levitt, Naomi S.

In: AIDS, Vol. 32, 01.07.2018, p. S5-S20.

Research output: Contribution to journalReview article

Patel, P, Rose, CE, Collins, PY, Nuche-Berenguer, B, Sahasrabuddhe, VV, Peprah, E, Vorkoper, S, Pastakia, SD, Rausch, D & Levitt, NS 2018, 'Noncommunicable diseases among HIV-infected persons in low-income and middle-income countries: A systematic review and meta-analysis', AIDS, vol. 32, pp. S5-S20. https://doi.org/10.1097/QAD.0000000000001888
Patel, Pragna ; Rose, Charles E. ; Collins, Pamela Y. ; Nuche-Berenguer, Bernardo ; Sahasrabuddhe, Vikrant V. ; Peprah, Emmanuel ; Vorkoper, Susan ; Pastakia, Sonak D. ; Rausch, Dianne ; Levitt, Naomi S. / Noncommunicable diseases among HIV-infected persons in low-income and middle-income countries : A systematic review and meta-analysis. In: AIDS. 2018 ; Vol. 32. pp. S5-S20.
@article{a63119a452c24b92975495afe3ed5f6a,
title = "Noncommunicable diseases among HIV-infected persons in low-income and middle-income countries: A systematic review and meta-analysis",
abstract = "Objective: 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. Design: Systematic review and meta-analysis. Methods: 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. Results: 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. Conclusion: 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.",
keywords = "health systems, HIV, integration, low-income and middle-income countries, noncommunicable disease",
author = "Pragna Patel and Rose, {Charles E.} and Collins, {Pamela Y.} and Bernardo Nuche-Berenguer and Sahasrabuddhe, {Vikrant V.} and Emmanuel Peprah and Susan Vorkoper and Pastakia, {Sonak D.} and Dianne Rausch and Levitt, {Naomi S.}",
year = "2018",
month = "7",
day = "1",
doi = "10.1097/QAD.0000000000001888",
language = "English (US)",
volume = "32",
pages = "S5--S20",
journal = "AIDS",
issn = "0269-9370",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Noncommunicable diseases among HIV-infected persons in low-income and middle-income countries

T2 - A systematic review and meta-analysis

AU - Patel, Pragna

AU - Rose, Charles E.

AU - Collins, Pamela Y.

AU - Nuche-Berenguer, Bernardo

AU - Sahasrabuddhe, Vikrant V.

AU - Peprah, Emmanuel

AU - Vorkoper, Susan

AU - Pastakia, Sonak D.

AU - Rausch, Dianne

AU - Levitt, Naomi S.

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Objective: 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. Design: Systematic review and meta-analysis. Methods: 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. Results: 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. Conclusion: 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.

AB - Objective: 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. Design: Systematic review and meta-analysis. Methods: 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. Results: 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. Conclusion: 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.

KW - health systems

KW - HIV

KW - integration

KW - low-income and middle-income countries

KW - noncommunicable disease

UR - http://www.scopus.com/inward/record.url?scp=85050143952&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85050143952&partnerID=8YFLogxK

U2 - 10.1097/QAD.0000000000001888

DO - 10.1097/QAD.0000000000001888

M3 - Review article

VL - 32

SP - S5-S20

JO - AIDS

JF - AIDS

SN - 0269-9370

ER -