Prevalence, Risk Factors, and Pathophysiology of Dysglycemia among People Living with HIV in Sub-Saharan Africa
Objective. To review available literature on the prevalence, risk factors, pathophysiology, and clinical outcomes of dysglycemia among people living with HIV (PLHIV) in sub-Saharan Africa (SSA). Methods. Database search on PUBMED for eligible studies describing the prevalence, risk factors, pathophy...
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doaj-d740a4dbf2d54a9ea98f6dec88fff81e2020-11-24T22:52:08ZengHindawi LimitedJournal of Diabetes Research2314-67452314-67532018-01-01201810.1155/2018/69164976916497Prevalence, Risk Factors, and Pathophysiology of Dysglycemia among People Living with HIV in Sub-Saharan AfricaBenson Njuguna0Jepchirchir Kiplagat1Gerald S. Bloomfield2Sonak D. Pastakia3Rajesh Vedanthan4John R. Koethe5Moi Teaching and Referral Hospital, P.O. Box 4606-30100, Eldoret, KenyaAcademic Model Providing Access to Healthcare (AMPATH), P.O. Box 4606-30100, Eldoret, KenyaDuke Clinical Research Institute, Duke Global Health Institute, Duke University, 2400 Pratt Street, Durham, NC 27710, USAPurdue University College of Pharmacy, P.O. Box 5760 Eldoret 30100, KenyaZena and Michael A. Wiener Cardiovascular Institute, Department of Medicine and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, P.O. Box 1030, New York, NY 10029, USADivision of Infectious Diseases, Vanderbilt University Medical Center, A2200-MCN 1161 21st Avenue South, Nashville, TN 37232, USAObjective. To review available literature on the prevalence, risk factors, pathophysiology, and clinical outcomes of dysglycemia among people living with HIV (PLHIV) in sub-Saharan Africa (SSA). Methods. Database search on PUBMED for eligible studies describing the prevalence, risk factors, pathophysiology, or clinical outcomes of dysglycemia in SSA PLHIV. Results. Prevalence of diabetes mellitus (DM) and pre-DM among SSA PLHIV ranged from 1% to 26% and 19% to 47%, respectively, in 15 identified studies. Older age and an elevated body mass index (BMI) were common risk factors for dysglycemia. Risk factors potentially more specific to PLHIV in SSA included exposure to older-generation thymidine analogues or protease inhibitors, malnutrition at ART initiation, a failure to gain fat mass on treatment, and elevated serum lipids. There is evidence of higher nephropathy and neuropathy rates among PLHIV in SSA with comorbid DM compared to HIV-negative individuals with DM. Conclusion. There is a need for longitudinal studies to enhance understanding of the risk factors for dysglycemia among PLHIV in SSA, further research into optimal therapies to reduce pre-DM progression to DM among SSA PLHIV, and studies of the burden and phenotype of diabetic complications and other health outcomes among PLHIV with comorbid DM in SSA.http://dx.doi.org/10.1155/2018/6916497 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Benson Njuguna Jepchirchir Kiplagat Gerald S. Bloomfield Sonak D. Pastakia Rajesh Vedanthan John R. Koethe |
spellingShingle |
Benson Njuguna Jepchirchir Kiplagat Gerald S. Bloomfield Sonak D. Pastakia Rajesh Vedanthan John R. Koethe Prevalence, Risk Factors, and Pathophysiology of Dysglycemia among People Living with HIV in Sub-Saharan Africa Journal of Diabetes Research |
author_facet |
Benson Njuguna Jepchirchir Kiplagat Gerald S. Bloomfield Sonak D. Pastakia Rajesh Vedanthan John R. Koethe |
author_sort |
Benson Njuguna |
title |
Prevalence, Risk Factors, and Pathophysiology of Dysglycemia among People Living with HIV in Sub-Saharan Africa |
title_short |
Prevalence, Risk Factors, and Pathophysiology of Dysglycemia among People Living with HIV in Sub-Saharan Africa |
title_full |
Prevalence, Risk Factors, and Pathophysiology of Dysglycemia among People Living with HIV in Sub-Saharan Africa |
title_fullStr |
Prevalence, Risk Factors, and Pathophysiology of Dysglycemia among People Living with HIV in Sub-Saharan Africa |
title_full_unstemmed |
Prevalence, Risk Factors, and Pathophysiology of Dysglycemia among People Living with HIV in Sub-Saharan Africa |
title_sort |
prevalence, risk factors, and pathophysiology of dysglycemia among people living with hiv in sub-saharan africa |
publisher |
Hindawi Limited |
series |
Journal of Diabetes Research |
issn |
2314-6745 2314-6753 |
publishDate |
2018-01-01 |
description |
Objective. To review available literature on the prevalence, risk factors, pathophysiology, and clinical outcomes of dysglycemia among people living with HIV (PLHIV) in sub-Saharan Africa (SSA). Methods. Database search on PUBMED for eligible studies describing the prevalence, risk factors, pathophysiology, or clinical outcomes of dysglycemia in SSA PLHIV. Results. Prevalence of diabetes mellitus (DM) and pre-DM among SSA PLHIV ranged from 1% to 26% and 19% to 47%, respectively, in 15 identified studies. Older age and an elevated body mass index (BMI) were common risk factors for dysglycemia. Risk factors potentially more specific to PLHIV in SSA included exposure to older-generation thymidine analogues or protease inhibitors, malnutrition at ART initiation, a failure to gain fat mass on treatment, and elevated serum lipids. There is evidence of higher nephropathy and neuropathy rates among PLHIV in SSA with comorbid DM compared to HIV-negative individuals with DM. Conclusion. There is a need for longitudinal studies to enhance understanding of the risk factors for dysglycemia among PLHIV in SSA, further research into optimal therapies to reduce pre-DM progression to DM among SSA PLHIV, and studies of the burden and phenotype of diabetic complications and other health outcomes among PLHIV with comorbid DM in SSA. |
url |
http://dx.doi.org/10.1155/2018/6916497 |
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