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非洲艾滋病毒感染者中的糖尿病、代谢综合征和血脂异常:不容忽视的新出现的挑战。

Diabetes, metabolic syndrome and dyslipidemia in people living with HIV in Africa: re-emerging challenges not to be forgotten.

作者信息

Husain Nazik Elmalaika, Noor Sufian K, Elmadhoun Wadie M, Almobarak Ahmed O, Awadalla Heitham, Woodward Clare L, Mital Dushyant, Ahmed Mohamed H

机构信息

Department of Pathology, Faculty of Medicine and Health Sciences, Omdurman Islamic University, Khartoum.

Department of Medicine.

出版信息

HIV AIDS (Auckl). 2017 Nov 8;9:193-202. doi: 10.2147/HIV.S137974. eCollection 2017.

Abstract

BACKGROUND

The current challenge in managing people living with human immunodeficiency virus (PLWHIV) includes the identification and monitoring for comorbid health risks associated with HIV and its treatment and longer survival. Dyslipidemia, diabetes mellitus and metabolic syndrome are increasingly seen in PLWHIV.

OBJECTIVE

In this narrative review, we aimed to summarize the current knowledge about diabetes, dyslipidemia and metabolic syndrome in PLWHIV in Africa and also to discuss the challenges that patients as well as health authorities in Africa may face.

METHODS

PubMed and Google scholar published-English literatures concerning earlier mentioned entities regardless of time limit were critically reviewed.

RESULTS

The prevalence of metabolic disorders in HIV population in Africa was estimated to range from 2.1% to 26.5% for diabetes and 20.2% to 43.5% for pre-diabetes, 13% to 58% for metabolic syndrome and 13% to 70% for dyslipidemia.

CONCLUSION

The management of metabolic disorders and cardiovascular disease risks related to HIV is complex especially in Africa due to healthcare resources, but our experience suggests that metabolic clinic is beneficial to patients and staff and should be an important part of HIV services especially as the older HIV population is increasing. In this context, cardiovascular risk assessment of HIV-infected patients will become an important component of care in developing countries in Africa and strategies are needed to deal with progressive increase in the epidemic of type 2 diabetes, dyslipidemia and metabolic syndrome.

摘要

背景

目前管理人类免疫缺陷病毒感染者(PLWHIV)面临的挑战包括识别和监测与HIV及其治疗以及更长生存期相关的合并健康风险。血脂异常、糖尿病和代谢综合征在PLWHIV中越来越常见。

目的

在这篇叙述性综述中,我们旨在总结非洲PLWHIV中关于糖尿病、血脂异常和代谢综合征的现有知识,并讨论非洲患者以及卫生当局可能面临的挑战。

方法

对PubMed和谷歌学术上发表的关于上述实体的英文文献进行严格审查,不限时间范围。

结果

非洲HIV人群中代谢紊乱的患病率估计为:糖尿病为2.1%至26.5%,糖尿病前期为20.2%至43.5%,代谢综合征为13%至58%,血脂异常为13%至70%。

结论

由于医疗资源的原因,与HIV相关的代谢紊乱和心血管疾病风险的管理尤其在非洲很复杂,但我们的经验表明,代谢门诊对患者和工作人员有益,应该成为HIV服务的重要组成部分,特别是随着老年HIV人群的增加。在这种情况下,对HIV感染患者进行心血管风险评估将成为非洲发展中国家护理的重要组成部分,并且需要制定策略来应对2型糖尿病、血脂异常和代谢综合征流行的逐步增加。

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