Prevalence of Non-Communicable Diseases among HIV Positive Patients on Antiretroviral Therapy at a Tertiary Health Facility in Makurdi, North-Central, Nigeria
Keywords:prevalence, Noncommunicable, Makurdi, hypertension, HIV, Diabetes mellitus
Background: Human immunodeficiency virus (HIV) treatment program has grown exponentially in Nigeria largely due to improved Antiretroviral therapy (ART) regimen which has changed the course of HIV/AIDs by enabling patients to live longer, raising concern of the co- existence of HIV with other chronic illnesses, notably non communicable diseases (NCDs). This study determined the prevalence of hypertension and diabetes mellitus among HIV positive patients in a tertiary institution in Makurdi, Northcentral Nigeria.
Methods: A cross-sectional study was conducted at the ART clinic among clients ≥ aged 21 years old living with HIV /or enrolled between October 2022, and March 30, 2023. The clients’ information was extracted from the register using a Proforma and all the clients who had attended their follow up clinic visit within the study period were included in the study. Data was analyzed using SPSS version 21.0. Categorical data were presented as frequencies and percentages.
Results: Among the 491 patients, 404 (82.3%) had HIV only and 87 (17.7%) had HIV and at least one comorbidity, namely DM and/or HTN. Hypertension was the most prevalent comorbidity affecting 15.5% of the patients while 1.0% of them were diabetic. The middle aged (30-49) patients, females (63.2%) had the highest prevalence of comorbidities and some of those with normal weight (35.6%) also had the highest prevalence of NCDs.
Conclusion: Non-communicable diseases are common among people living with HIV. There is need to encourage early diagnosis and treatment of noncommunicable diseases in HIV positive patients in Nigeria.
UNAIDS, fact sheet 2018. UNAIDS. Accessed at https://www.unaids.org/en/resources/documents/2018/unaids-data-2018 on the 21st of July 2023
Understanding the HIV epidemic. Accessed at https://www.beintheknow.org/understanding-hivepidemic/data/glance-hiv-nigeria on the 21st of June 2023
Haregu T.N., Oldenberg B, Setswe G, Elliot J, Nanayakkara V. Epidemiology of Comorbidity of HIV/AIDS and Non-Communicable Diseases in
Developing Countries: A systematic review. 2012; 2(1) 1-13
Antiretroviral Therapy Cohort Collaboration. Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies. The Lancet. 2008;372(9635):293–299.
WHO, Non-communicable diseases, Accessed at https://www.who.int/news-room/factsheets/detail/noncommunicable-diseases on the 21st
of July 2023
Non-Communicable Diseases Deemed Development Challenge of ‘Epidemic Proportions’ in Political Declaration Adopted During Landmark General Assembly Summit. (2011) United Nations. Department of Public Information. Accessed at https://press.un.org/en/2011/ga11138.doc.htm on the 21st July 2023
Kontis V, Mathers CD, Rehm J, Stevens GA, Shield KD, Bonita R et al. Contribution of six risk factors to achieving the 25× 25 non-communicable disease mortality reduction target: a modelling study. Lancet. 2014; 384:427–437.
Alleyne G, Binagwaho A, Haines A, Jahan S, Nugent R, Rojhani A, Stuckler D, Lancet NCD. Action Group. Embedding non-communicable diseases in the post- 2015 development agenda. The Lancet. 2013;381(9866):566–574.
Bonita R, Magnusson R, Bovet P, Zhao D, Malta DC, Geneau R, Suh I, Thankappan KR, McKee M, Hospedales J, De Courten M. Country actions to meet UN commitments on non-communicable diseases: a STEPwise approach. The Lancet. 2013;381(9866):575– 84.
Van Wijk JP, Cabezas MC. Hypertriglyceridemia, metabolic syndrome, and cardiovascular disease in HIV-infected patients: effects of antiretroviral therapy and adipose tissue distribution. International Journal of Vascular Medicine. 2012; 2012:1–13
Abebe SM, Getachew A, Fasika S, Bayisa M, Girma Demisse A, Mesfin N. Diabetes mellitus among HIVinfected individuals in follow-up care at University of Gondar Hospital, Northwest Ethiopia. BMJ Open. 2016;6(8):e011175. 10.1136/bmjopen-2016-011175
Sherer R, Solomon S, Schechter M, Nachega JB, Rockstroh J, Zuniga JM. HIV provider-patient communication regarding cardiovascular risk: results from the AIDS Treatment for Life International Survey. J Int Assoc Provid AIDS Care. 2014;13(4):342– 345.
Denue BA, Muazu PJ, Gashau W, Nkami D, Ajayi NA. Effects of highly active antiretroviral therapy (HAART) on blood pressure changes and its associated factors in HAART naive HIV-infected patients in northeastern Nigeria. Arch Appl Sci Res. 2012;4(3):1447-1452.
WHO. Consolidated Guidelines on the use of Antiretroviral Drugs for Treating and Preventing HIV Infection Recommendations for A Public Health Approach. 2013. Accessed at https://www.ncbi.nlm.nih.gov/books/NBK374294/ on the 26th of June 2023
Dalsone K, Laura B, David H, et al. Population-based assessment of hypertension epidemiology and risk factors among HIV-positive and general populations in rural Uganda. PLoS One. 2016;11(5): e0156309
Baekken M, Os I, Sandvik L, Oektedalen O. Hypertension in an urban HIV-positive population compared with the general population: influence of combination antiretroviral therapy. J Hypertens. 2008;26(11):2126–2133.
Ataro Z, Ashenafi W, Fayera J, Abdosh T. Magnitude and associated factors of diabetes mellitus and hypertension among adult HIV-positive individuals receiving highly active antiretroviral therapy at Jugal Hospital, Harar, Ethiopia. Hiv Aids (Auckl). 2018; 10:181–192.
Isa SE, Kang´ombe AR, Simji GS, Shehu NY, Oche AO, Idoko JA, et al. Hypertension in treated and untreated patients with HIV? A study from 2011 to 2013 at the Jos University Teaching Hospital, Nigeria. Trans R Soc Trop Med Hyg. 2017;111(4):172–177.
Merle M, Eduard P, Ehrin A, Shari K, Victoria S, Heejung B. Prevalence, Treatment, and Control of Dyslipidemia and Hypertension in 4278 HIV Outpatients. J Acquir Immune Defic Syndr. 2014;66(4):370–377.
Hejazi N, Huang MSL, Lin KG, Choong LCK. Hypertension among HIV-infected adults receiving highly active antiretroviral therapy (HAART) in Malaysia. Glob J Health Sci. 2013;6(2):58–71.
Abebe SM, Getachew A, Fasika S, Bayisa M, Girma Demisse A, Mesfin N. Diabetes mellitus among HIVinfected individuals in follow-up care t University of Gondar Hospital, Northwest Ethiopia. BMJ Open. 2016;6(8):e011175. 10.1136/bmjopen-2016-011175
Samaras K, Wand H, Law M, Emery S, Cooper D, Carr A. Prevalence of metabolic syndrome in HIV-infected patients receiving highly active antiretroviral therapy using International Diabetes Foundation and Adult Treatment Panel III criteria: Associations with insulin resistance, disturbed body fat compartmentalization, elevated C-reactive protein, and [corrected] hypoadiponectinemia. Diabetes Care 2007;30(1):113–
Monroe AK, Glesby MJ, Brown TT. Diagnosing and managing diabetes in HIV-infected patients: Current concepts. Clin Infect Dis. 2014;60(3):453–462.
Galli L, Salpietro S, Pellicciotta G, et al. Risk of type 2 diabetes among HIV-infected and healthy subjects in Italy. Eur J Epidemiol. 2012;27(8):657–665.
Noubissi EC, Katte JC, Sobngwi E. Diabetes and HIV. Curr Diab Rep. 2018;18(11):125. 10.1007/s11892-018-1076-3
Rasmussen LD, Mathiesen ER, Kronborg G, Pedersen C, Gerstoft J, Obel N. Risk of diabetes mellitus in persons with and without HIV: A Danish nationwide population-based cohort study. PLoS One. 2012;7:e44575. 10.1371
Butt AA, McGinnis K, Rodriguez-Barradas MC, et al. HIV infection and the risk of diabetes mellitus. AIDS (London, England). 2009;23(10):1227– 1234.
Knowledge Translation Unit UoCTLI. Adult primary care guide (APC) 2019/2020. Pretoria: The National Department of Health of South Africa; 2019 Accessed at https://knowledgehub.health.gov.za/elibrary/adultprimary-care-apc-guide-20192020-updated on the 15th of June 2023
Magodoro IM, Esterhuizen TM, Chivese T. A crosssectional, facility base study of comorbid noncommunicable diseases among adults living with HIV infection in Zimbabwe. BMC Res Notes. 2016; 9:379.
Kwarisiima D, Balzer L, Heller D, Kotwani P, Chamie G, Clark T, et al. Population-Based Assessment of Hypertension Epidemiology and Risk Factors among HIV-Positive and General Populations in Rural Uganda. PLoS One. 2016;11(5):e0156309.
Shisana O, Labadarios D, Rehle T, Simbayi L, Zuma K, Dhansay A, et al. The south African National Health and nutrition examination survey, 2012: SANHANES- 1: the health and nutritional status of the nation. 2014.
Zungu NP, Mabaso ML, Kumalo F, Sigida S, Mlangeni L, Wabiri N, et al. Prevalence of non-communicable diseases (NCDs) and associated factors among HIV positive educators: findings from the 2015/6 survey of health of educators in public schools in South Africa. PLoS One. 2019;14(2):e0209756.
Antonello VS. Carlos Ferreira Antonello I, Grossmann TK, Tovo CV, Brasil dal Pupo B, de Quadros Winckler L. hypertension—an emerging cardiovascular risk factor in HIV infection. J Am Soc Hypertens. 2015;9(5):403–407.
Petrie JR, Guzik TJ, Touyz RM. Diabetes, hypertension, and cardiovascular disease: clinical insights and vascular mechanisms. Can J Cardiol.
Friis-Moller N, Weber R, Reiss P, Thiebaut R, Kirk O, d’Arminio Monforte A, et al. Cardiovascular disease risk factors in HIV patients: association with antiretroviral therapy. Results from the DAD study. AIDS. 2003; 17:1179–1193.
Lipshultz SE, Mas CM, Henkel JM, Franco VI, Fisher SD, Miller TL. HAART to heart: highly active antiretroviral therapy and the risk of cardiovascular disease in HIV-infected or exposed children and adults. Expert Rev Anti Infect Ther. 2012;10: 661–674.
How to Cite
Copyright (c) 2023 Journal and Publisher
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The Journal is owned, published and copyrighted by the Nigerian Medical Association, River state Branch. The copyright of papers published are vested in the journal and the publisher. In line with our open access policy and the Creative Commons Attribution License policy authors are allowed to share their work with an acknowledgement of the work's authorship and initial publication in this journal.
This is an open access journal which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles in this journal without asking prior permission from the publisher or the author.
The use of general descriptive names, trade names, trademarks, and so forth in this publication, even if not specifically identified, does not imply that these names are not protected by the relevant laws and regulations. While the advice and information in this journal are believed to be true and accurate on the date of its going to press, neither the authors, the editors, nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
TNHJ also supports open access archiving of articles published in the journal after three months of publication. Authors are permitted and encouraged to post their work online (e.g, in institutional repositories or on their website) within the stated period, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access). All requests for permission for open access archiving outside this period should be sent to the editor via email to firstname.lastname@example.org.