The human immunodeficiency virus and the cardiometabolic syndrome in the developing world: an African perspective.
The advent of highly active antiretroviral therapy (HAART) has transformed human immunodeficiency virus (HIV)/AIDS into a manageable chronic disorder. Clinical care, however, needs to address the metabolic, anthropometric, and cardiovascular changes associated with HIV infection and HAART. Studies in developing countries suggest an increasing incidence of HIV-associated cardiometabolic syndrome (CMS), especially in urban settings. Predictions indicate that the greatest increase in the prevalence of diabetes will occur in Africa over the next 2 decades due to lifestyle changes. This, coupled with increased access to HAART, may exponentially increase the prevalence of CMS in developing countries, where HIV infection is prevalent. Appropriate evaluation and intervention programs need to be implemented in the developing world, especially sub-Saharan Africa, to curtail HIV-related CMS. This should include routine cardiovascular risk assessments, management of HIV infection with more "metabolically friendly" HAART, and encouragement of lifestyle modifications, particularly smoking cessation, weight management, regular exercise, and adherence to a healthy diet.
Mutimura
Eugene
E
Faculty of Allied Health Sciences and Programs in HIV/AIDS Clinical Research and Community Interventions, Kigali Health Institute, Kigali, Rwanda. eumuran@yahoo.co.uk
Crowther
Nigel J
NJ
Stewart
Aimee
A
Cade
W Todd
WT
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D017954:Africa South of the Sahara / Q000453:epidemiology; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000453:epidemiology; D003906:Developing Countries / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology; D004032:Diet; D006678:HIV / Q000187:drug effects*; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008019:Life Style; D024821:Metabolic Syndrome / Q000139:chemically induced* / Q000453:epidemiology; D009752:Nutritional Status; D015995:Prevalence; D012432:Rwanda / Q000453:epidemiology; D013577:Syndrome; D014505:Urban Population / Q000706:statistics & numerical data