Noninfectious Comorbidity in the African Cohort Study

Area of Science:

• Global Health
• Infectious Diseases
• Epidemiology

Background:

• Noninfectious comorbid diseases (NCDs) significantly impact morbidity and mortality in human immunodeficiency virus (HIV)-infected populations.
• The scale-up of antiretroviral therapy (ART) in Africa necessitates a deeper understanding of the NCD burden among HIV-infected individuals.

Purpose of the Study:

• To assess the prevalence and associated factors of NCDs in HIV-infected participants in African clinics.
• To inform public health strategies by understanding the NCD burden in the context of ART scale-up.

Main Methods:

• Cross-sectional study at 11 HIV clinics in Kenya, Uganda, Tanzania, and Nigeria.
• Participants underwent medical history, physical, laboratory, and neuropsychological assessments.
• Poisson and logistic regression models were used to analyze the association between HIV, ART, and NCDs.

Main Results:

• Of 2720 participants, 79.4% were HIV-infected, and 37.7% had at least one NCD.
• HIV infection, particularly with ART, was associated with a higher number of NCDs (ARR, 1.42).
• ART use was linked to more NCDs, hypercholesterolemia, and dysglycemia; low CD4 nadir also increased NCD risk.

Conclusions:

• HIV infection is a significant risk factor for NCDs in this African cohort.
• NCDs were common, geographically variable, and associated with metabolic complications of first-line ART.
• Findings highlight the need for integrated NCD management in HIV care programs in resource-limited settings.