Non-communicable diseases by age strata in people living with and without HIV in four African countries

被引：11

作者：

Chang, David ^{[1
]}

Esber, Allahna L. ^{[1
,2
]}

Dear, Nicole F. ^{[1
,2
]}

Iroezindu, Michael ^{[1
,3
]}

Bahemana, Emmanuel ^{[1
,4
]}

Kibuuka, Hannah ^{[5
]}

Owuoth, John ^{[6
,7
]}

Maswai, Jonah ^{[1
,8
]}

Crowell, Trevor A. ^{[1
,2
]}

Polyak, Christina S. ^{[1
,2
]}

Cavanaugh, Joseph S. ^{[1
]}

Ake, Julie A. ^{[1
]}

Godfrey, Catherine ^{[9
]}

机构：

[1] Walter Reed Army Inst Res, US Mil HIV Res Program, 503 Robert Grant Ave, Silver Spring, MD 20910 USA

[2] Henry M Jackson Fdn Adv Mil Med Inc, Bethesda, MD USA

[3] HJF Med Res Int, Abuja, Nigeria

[4] HJF Med Res Int, Mbeya, Tanzania

[5] Makerere Univ, Walter Reed Project, Kampala, Uganda

[6] US Army Med Res Directorate Africa, Kisumu, Kenya

[7] HJF Med Res Int, Kisumu, Kenya

[8] HJF Med Res Int, Kericho, Kenya

[9] Off Global AIDS Coordinator, Dept State, Washington, DC USA

来源：

JOURNAL OF THE INTERNATIONAL AIDS SOCIETY | 2022年 / 25卷

关键词：

Africa; LMIC; HIV epidemiology; quality of life; cohort studies; HIV care continuum; LIFE EXPECTANCY; ANTIRETROVIRAL THERAPY; INFECTION; TRENDS;

D O I：

10.1002/jia2.25985

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Introduction Non-communicable diseases (NCDs) are an important driver of morbidity among ageing people living with HIV (PLWH). We examined the composite role of age and HIV status on NCDs in people living with and without HIV. Methods The African Cohort Study (AFRICOS) prospectively enrols participants aged >= 15 years with and without HIV at 12 sites in Kenya, Tanzania, Uganda and Nigeria. From 21 January 2013 to 1 September 2021, we assessed participants for renal insufficiency (estimated glomerular filtration rate <60 ml/minute/1.73 m(2)), elevated blood pressure (BP) (any systolic BP >139 mmHg or diastolic BP >89 mmHg), obesity (body mass index >30 kg/m(2)), diabetes mellitus (DM) (fasting glucose >= 126 mg/dl or antidiabetic medication) and dysglycemia (fasting glucose >= 99 mg/dl or non-fasting >= 199 mg/dl). Multivariable logistic regression with generalized estimating equations was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with each NCD. The main exposure of interest was a composite of HIV status and age dichotomized around 50 years. All models were adjusted for study site and sex. The renal insufficiency model was additionally adjusted for elevated BP and dysglycemia. Results and discussion Of 3761 participants with age data, 557 (14.8%) were age >= 50, 2188 (58.2%) were females and 3099 (82.4%) were PLWH. At enrolment, the prevalence of elevated BP, dysglycemia, renal insufficiency and obesity were n = 128 (26.9%), n = 75 (15.8%), n = 8 (1.7%) and n = 40 (8.4%), respectively, for PLWH >= 50. Compared to people without HIV age <50, PLWH age >= 50 had increased adjusted odds of having DM (OR: 2.78, 95% CI: 1.49-5.16), dysglycemia (OR: 1.98, 95% CI: 1.51-2.61) and renal insufficiency (OR: 6.20, 95% CI: 2.31-16.66). There were significant differences by study site, specifically, participants from Nigeria had the highest odds of elevated BP, dysglycemia and renal insufficiency as compared to Uganda. Conclusions There was a high burden of NCDs in this African cohort with differences by geographic region. In order to promote healthy ageing with HIV, screening and treatment for common NCDs should be incorporated into routine HIV care with attention paid to geographic heterogeneity to better allocate resources.

引用

页数：7

共 27 条

[11] Weight gain during the dolutegravir transition in the African Cohort Study [J].