title: HIV with non-communicable diseases in primary care in Kibera, Nairobi, Kenya: characteristics and outcomes 2010-2013.
abstract: BACKGROUND
  Antiretroviral therapy (ART) has increased the life expectancy of people living with HIV (PLHIV); HIV is now considered a chronic disease. Non-communicable diseases (NCDs) and HIV care were integrated into primary care clinics operated within the informal settlement of Kibera, Nairobi, Kenya. We describe early cohort outcomes among PLHIV and HIV-negative patients, both of whom had NCDs.
  
  
  METHODS
  A retrospective analysis was performed of routinely collected clinic data from January 2010 to June 2013. All patients >14 years with hypertension and/or diabetes were included.
  
  
  RESULTS
  Of 2206 patients included in the analysis, 210 (9.5%) were PLHIV. Median age at enrollment in the NCD program was 43 years for PLHIV and 49 years for HIV-negative patients (p<0.0001). The median duration of follow up was 1.4 (IQR 0.7-2.1) and 1.0 (IQR 0.4-1.8) years for PLHIV and HIV-negative patients, respectively (p=0.003). Among patients with hypertension, blood pressure outcomes were similar, and for those with diabetes, outcomes for HbA1c, fasting glucose and cholesterol were not significantly different between the two groups. The frequency of chronic kidney disease (CKD) was 12% overall. Median age for PLHIV and CKD was 50 vs 55 years for those without HIV (p=0.005).
  
  
  CONCLUSIONS
  In this early comparison of PLHIV and HIV-negative patients with NCDs, there were significant differences in age at diagnosis but both groups responded similarly to treatment. This study suggests that integrating NCD care for PLHIV along with HIV-negative patients is feasible and achieves similar results.
authors.affiliation: Médecins Sans Frontières, Nairobi, Kenya jeffreykedwards@gmail.com.
authors.forename: Jeffrey K
authors.initials: JK
authors.lastname: Edwards
authors.affiliation: Médecins Sans Frontières, Southern Africa Medical Unit, Cape Town, South Africa.
authors.forename: Helen
authors.initials: H
authors.lastname: Bygrave
authors.affiliation: Medical Department, Luxembourg Operational Research Unit, Operational Center Brussels, Médecins Sans Frontières, Brussels, Belgium.
authors.forename: Rafael
authors.initials: R
authors.lastname: Van den Bergh
authors.affiliation: Médecins Sans Frontières, Nairobi, Kenya.
authors.forename: Walter
authors.initials: W
authors.lastname: Kizito
authors.affiliation: Médecins Sans Frontières, Nairobi, Kenya.
authors.forename: Erastus
authors.initials: E
authors.lastname: Cheti
authors.affiliation: University of Nairobi, Department of Obstetrics and Gynaecology, Nairobi, Kenya.
authors.forename: Rose J
authors.initials: RJ
authors.lastname: Kosgei
authors.affiliation: Médecins Sans Frontières, Nairobi, Kenya.
authors.forename: Agnès
authors.initials: A
authors.lastname: Sobry
authors.affiliation: Médecins Sans Frontières, Nairobi, Kenya.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Vandenbulcke
authors.affiliation: Kenya National AIDs and STI Control Program/HRH Capacity Bridge Project, Nairobi, Kenya.
authors.forename: Shobha N
authors.initials: SN
authors.lastname: Vakil
authors.affiliation: Medical Department, Luxembourg Operational Research Unit, Operational Center Brussels, Médecins Sans Frontières, Brussels, Belgium.
authors.forename: Tony
authors.initials: T
authors.lastname: Reid
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001786:Blood Glucose; D001794:Blood Pressure / Q000502:physiology; D002784:Cholesterol / Q000097:blood; D015897:Comorbidity; D019033:Delivery of Health Care, Integrated; D003920:Diabetes Mellitus / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology; D012189:Retrospective Studies; D017741:Survivors
chemical_list: D019380:Anti-HIV Agents; D001786:Blood Glucose; D002784:Cholesterol; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Africa; Chronic kidney disease; Diabetes; HIV; Hypertension; Non-communicable diseases