title: Prevalence and incidence of pulmonary hypertension among HIV-infected people in Africa: a systematic review and meta-analysis.
abstract: Patients infected with HIV have a direly increased risk of developing pulmonary hypertension (PH), and of dying from the condition. While Africa carries the greatest burden of HIV infection worldwide, there is unclear data summarising the epidemiology of PH among HIV-infected people in this region. Our objective was to determine the prevalence and incidence of PH among HIV-infected people living across Africa.
  
  
  
  A systematic review and meta-analysis.
  
  
  
  HIV-infected African people residing in Africa.
  
  
  
  Prevalence and incidence of PH diagnosed through echocardiography or right heart catheterisation.
  
  
  
  Articles published in PubMed/MEDLINE, EMBASE, African Journals Online and African Index Medicus between 1 January 1980 and 30 June 2016, without any language restriction.
  
  
  
  Overall, 121 studies were screened; 3 were included in this review: 1 from Southern Africa (South Africa), 1 from Eastern Africa (Tanzania) and 1 from Central Africa (Cameroon). These studies included HIV-infected adult patients selected based on presentation with cardiovascular symptoms. No study reported PH incidence or PH incidence/prevalence among children and adolescents. The quality assessment yielded moderate risk of bias. Ages of participants ranged between 18 and 78 years, and the proportion of females varied between 52.3% and 68.8%. The prevalence of PH in the pooled sample of 664 patients was 14% (95% CI 6%-23%).
  
  
  
  Only 3 studies were found eligible from 3 regions of the African continent.
  
  
  
  The prevalence of PH among HIV-infected people in Africa seems very high. Further studies are urgently warranted to determine the incidence of HIV-induced PH, which must include all subregions of Africa.
  
  
  
  Review registration number PROSPERO CRD42016033863.
authors.affiliation: Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaoundé, Cameroon Bordeaux School of Public Health, University of Bordeaux, Bordeaux, France.
authors.forename: Jean Joel R
authors.initials: JJ
authors.lastname: Bigna
authors.affiliation: Faculty of Medicine and Biomedical Sciences, Department of Public Health, University of Yaoundé 1, Yaoundé, Cameroon Sickle Cell Disease Unit, Mother and Child Centre of the Chantal Biya Foundation, Yaoundé, Cameroon.
authors.forename: Jobert Richie N
authors.initials: JR
authors.lastname: Nansseu
authors.affiliation: Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
authors.forename: Lewis N
authors.initials: LN
authors.lastname: Um
authors.affiliation: Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
authors.forename: Steve Raoul N
authors.initials: SR
authors.lastname: Noumegni
authors.affiliation: Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
authors.forename: Paule Sandra D
authors.initials: PS
authors.lastname: Simé
authors.affiliation: Faculty of Medicine and Biomedical Sciences, School of Public Health, University of Queensland, Brisbane, Queensland, Australia Clinical Research Education, Networking and Consultancy (CRENC), Douala, Cameroon.
authors.forename: Leopold Ndemngue
authors.initials: LN
authors.lastname: Aminde
authors.affiliation: Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon Infectious Diseases Unit, Yaoundé Central Hospital, Yaoundé, Cameroon.
authors.forename: Sinata
authors.initials: S
authors.lastname: Koulla-Shiro
authors.affiliation: Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa Medical Diagnosis Center, Yaoundé, Cameroon.
authors.forename: Jean Jacques N
authors.initials: JJ
authors.lastname: Noubiap
mesh_terms: D000349:Africa / Q000453:epidemiology; D006328:Cardiac Catheterization; D004452:Echocardiography; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D015995:Prevalence; D012306:Risk
keywords: AIDS; Africa; HIV; Pulmonary arterial hypertension; Pulmonary hypertension