HIV and metabolic, body, and bone disorders: what we know from low- and middle-income countries

J Acquir Immune Defic Syndr. 2014 Sep 1:67 Suppl 1:S27-39. doi: 10.1097/QAI.0000000000000256.

Abstract

Globally, the HIV epidemic is evolving. Life expectancy for HIV-infected individuals has been extended because of more effective and more widely available antiretroviral therapy. As a result, chronic noncommunicable diseases (NCDs) have become important comorbid conditions. In particular, HIV-infected persons are increasingly at risk of developing metabolic (diabetes, dyslipidemias), body composition (lipodystrophy, overweight/obesity) and bone mineral density abnormalities. We have summarized the published epidemiological and clinical literature regarding these HIV-NCD comorbidities in low- and middle-income countries (LMICs). We found important gaps in knowledge. Specifically, there are few studies that use standardized methods and metrics; consequently, prevalence or incidence data are not comparable. There are very little or no data regarding the effectiveness or cost-effectiveness of clinical monitoring or therapeutic interventions for metabolic disorders in HIV-infected individuals. Also, although NCDs continue to grow in the HIV-negative population of most LMICs, there are few data comparing the incidence of NCD comorbidities between HIV-infected and HIV-negative populations. To address these gaps, we describe potential research and capacity development priorities for the future.

Publication types

  • Review

MeSH terms

  • Bone Diseases / diagnosis
  • Bone Diseases / epidemiology*
  • Bone Diseases / therapy
  • Developing Countries
  • HIV Infections / complications*
  • HIV Infections / epidemiology*
  • HIV-Associated Lipodystrophy Syndrome / diagnosis
  • HIV-Associated Lipodystrophy Syndrome / epidemiology*
  • HIV-Associated Lipodystrophy Syndrome / therapy
  • Humans
  • Incidence
  • Metabolic Diseases / diagnosis
  • Metabolic Diseases / epidemiology*
  • Metabolic Diseases / therapy
  • Obesity / diagnosis
  • Obesity / epidemiology*
  • Obesity / therapy
  • Prevalence
  • Research