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Current co-morbidities burden in patients living with HIV in low- and middle-income countries
Ponego Lloyd Ponatshego1, Nabila Farah Youssouf2, Mosepele Mosepele3,4
1Research Physician and Principal Investigator, Botswana Harvard HIV/AIDS Partnership.
Insights
People with HIV in sub-Saharan Africa face increased cardiovascular disease risk due to aging, HIV itself, and antiretroviral therapy. Integrating cardiovascular care into HIV services is crucial for managing this growing health burden.
Area of Science:
- Public Health
- Infectious Diseases
- Cardiology
Background:
- The global human immunodeficiency virus (HIV) burden is concentrated in low- to middle-income countries, particularly in sub-Saharan Africa.
- Well-controlled HIV infection is increasingly associated with age-related comorbidities, including cardiovascular disease (CVD).
- Antiretroviral therapy (ART) and HIV itself may contribute to CVD development, posing a significant challenge to regional healthcare systems.
Purpose of the Study:
- To review common comorbidities in people living with HIV (PLWHIV) in low- to middle-income countries, with a focus on the sub-Saharan region.
- To investigate the specific risks and prevalence of cardiovascular disease among PLWHIV.
- To explore the implications of increased longevity and comorbidities for healthcare infrastructure.
Main Methods:
- This review synthesizes findings from recent studies on HIV comorbidities.
- It examines the impact of antiretroviral therapy and HIV disease on cardiovascular health.
- The review assesses markers of inflammation (albuminuria) and frailty in PLWHIV.
Main Results:
- HIV disease and its treatment, alongside natural aging, increase the risk of cardiovascular disease in PLWHIV.
- Albuminuria and frailty are more prevalent in PLWHIV compared to the general population, leading to higher morbidity and mortality.
- Despite improved ART availability and tolerance, cardiovascular complications present a new and substantial health burden.
Conclusions:
- Cardiovascular complications are a significant concern for the aging HIV population in sub-Saharan Africa.
- There is a critical need to integrate cardiovascular care services within existing HIV care programs.
- Proactive management of cardiovascular risk factors is essential to improve long-term outcomes for PLWHIV.
Purpose Of Review:
The present review aims to decipher common co-morbidities faced by people living with HIV in low- to middle-income countries, and in particular the sub-Saharan region, which hosts the majority of the HIV burden worldwide.
Recent Findings:
Well-controlled chronic HIV disease is strongly associated with an increased risk of developing cardiovascular disease. This is partly due to the natural aging process, however recent studies show that using antiretroviral therapy as well as the HIV disease itself may be predisposing factors to the development of cardiovascular diseases, creating a new burden for healthcare facilities in the region. Furthermore, newly completed studies assessing inflammation marker albuminuria and age-related syndrome frailty have been found in a higher prevalence than in non-HIV people, with increased morbidity and mortality.
Summary:
As antiretroviral medication continues to be well supplied in the region and well tolerated by patients living with HIV, this group is now reckoning with cardiovascular ailments faced by all ageing population therefore there is a need for cardiovascular care systems to be better integrated within the existing, well-performing HIV care cascade to address this burden.
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