title: HIV and metabolic, body, and bone disorders: what we know from low- and middle-income countries.
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.
authors.affiliation: *Rollins School of Public Health, Emory University, Atlanta, GA; †Medical School, University of Cape Town, Cape Town, South Africa; ‡School of Medicine, Emory University, Atlanta, GA; §The Cleveland Clinic, Cleveland, OH; and ‖Veterans Affairs Medical Center, Atlanta, GA.
authors.forename: Mohammed K
authors.initials: MK
authors.lastname: Ali
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Magee
authors.forename: Joel A
authors.initials: JA
authors.lastname: Dave
authors.forename: Igho
authors.initials: I
authors.lastname: Ofotokun
authors.forename: Marisa
authors.initials: M
authors.lastname: Tungsiripat
authors.forename: Trammell K
authors.initials: TK
authors.lastname: Jones
authors.forename: Naomi S
authors.initials: NS
authors.lastname: Levitt
authors.forename: David
authors.initials: D
authors.lastname: Rimland
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Armstrong
mesh_terms: D001847:Bone Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D003906:Developing Countries; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D008659:Metabolic Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D015995:Prevalence; D012106:Research