Kilimanjaro Christian Medical University College, Moshi, Tanzania.
Kilimanjaro Christian Medical Center, Moshi, Tanzania.
PLoS One. 2023 May 8;18(5):e0285472. doi: 10.1371/journal.pone.0285472. eCollection 2023.
People with HIV in sub-Saharan Africa are increasingly developing age-related comorbidities. The purpose of this prospective observational study was to describe 6-month outcomes among Tanzanians with HIV and elevated blood pressure or hyperglycemia under current care pathways.
Adults presenting for routine HIV care were enrolled and underwent blood pressure and blood glucose measurements. Participants with abnormal blood pressure or glucose were referred for further care, as per current guidelines. Participants' blood pressure and point-of-care glucose were re-evaluated during their 6-month follow-up visit. Elevated blood pressure was defined as systolic ≥140 mmHg or diastolic ≥90 mmHg. Hyperglycemia was defined as fasting glucose ≥126 mg/dl or random glucose ≥200 mg/dl. An electrocardiogram was obtained at enrollment and at follow-up. Interim myocardial infarction and interim myocardial ischemia were defined as new pathologic Q waves and new T-wave inversions, respectively.
Of 500 participants, 155 had elevated blood pressure and 17 had hyperglycemia at enrolment. At 6-month follow-up, 7 (4.6%) of 155 participants with elevated blood pressure reported current use of an anti-hypertensive medication, 100 (66.2%) had persistent elevated blood pressure, 12 (7.9%) developed interim myocardial infarction, and 13 (8.6%) developed interim myocardial ischemia. Among 17 participants with hyperglycemia, 9 (56%) had persistent hyperglycemia at 6 months and 2 (12.5%) reported current use of an anti-hyperglycemic medication.
Interventions are needed to improve non-communicable disease care pathways among Tanzanians with HIV.
撒哈拉以南非洲的艾滋病毒感染者越来越多地出现与年龄相关的合并症。本前瞻性观察研究的目的是描述在当前护理途径下，坦桑尼亚艾滋病毒感染者中血压升高或血糖升高的 6 个月结局。
纳入前来进行常规艾滋病毒护理的成年人，并进行血压和血糖测量。根据当前指南，将血压或血糖异常的参与者转介进行进一步治疗。在 6 个月的随访期间，重新评估参与者的血压和即时血糖。血压升高定义为收缩压≥140mmHg 或舒张压≥90mmHg。高血糖定义为空腹血糖≥126mg/dl 或随机血糖≥200mg/dl。在入组时和随访时获得心电图。中期心肌梗死和中期心肌缺血分别定义为新出现病理性 Q 波和新 T 波倒置。
在 500 名参与者中，155 名在入组时血压升高，17 名血糖升高。在 6 个月的随访中，155 名血压升高的参与者中，有 7 名（4.6%）报告目前正在使用抗高血压药物，100 名（66.2%）仍有血压升高，12 名（7.9%）发生中期心肌梗死，13 名（8.6%）发生中期心肌缺血。在 17 名血糖升高的参与者中，有 9 名（56%）在 6 个月时仍有高血糖，有 2 名（12.5%）报告目前正在使用抗高血糖药物。
需要采取干预措施，改善坦桑尼亚艾滋病毒感染者的非传染性疾病护理途径。
