超越病毒载量：解读津巴布韦马尼卡兰省的非传染性疾病模式

Beyond viral load: Unravelling non-communicable disease patterns in Manicaland province, Zimbabwe.

作者信息

Chokuona Kudzai F V, Mukuzunga Munyaradzi, Juru Tsitsi P, Chadambuka Addmore, Shambira Gerald, Gombe Notion T, Tshimanga Mufuta

机构信息

Department of Primary Health Care Sciences, Faculty of Family Medicine, Global and Public Health Unit, University of Zimbabwe, Harare, Zimbabwe.

Manicaland Provincial Medical Directorate, Ministry of Health and Childcare, Mutare, Zimbabwe.

出版信息

J Public Health Afr. 2025 May 13;16(1):587. doi: 10.4102/jphia.v16i1.587. eCollection 2025.

BACKGROUND

Non-communicable diseases (NCDs) among people living with human immunodeficient virus (HIV) are emerging and a leading cause of death in this population.

AIM

To identify disease trends, prevalence and outcomes of NCDs among PLHIV.

SETTING

The study was conducted in Manicaland province.

METHODS

We reviewed secondary data from October 2013 to September 2023. Data on five priority NCDs were analysed: hypertension (HPT), diabetes mellitus (DM), chronic kidney injury (CKD), cancers and chronic respiratory conditions (CRC). Kaplan-Meier analysis and Cox proportional hazard analysis were performed, risk and hazard ratios reported at the 95% confidence level.

RESULTS

A total of patient files were reviewed. The median age was () years. A total of (%) were males and (%) were females. A total of (%) patients had HPT, (%) had DM, (%) had CKD, (%) had cancer and (%) had CRC. Controlling for age, gender and medication use, being on ART for more than 5 years and ageing were hazards to DM and HPT. Protease inhibitor-based regimen was a hazard to DM (hazard ratio [HR] % ). Efavirenz-based regimen was protective in development of HPT (% ), = 0.01.

CONCLUSION

Hypertension and DM are the most common NCDs among people living with HIV. Prevalence of HPT and DM increased with age and duration on ART. To minimise complications related to NCD and HIV comorbidities, we recommend regular screening of NCDs at least monthly, and personalising treatment for hypertensive patients to efavirenz based regimens. We educated people living with HIV about the risks of NCDs and importance of healthy eating and regular exercise.

CONTRIBUTION

Integrated NCD and HIV care models.

背景

人类免疫缺陷病毒（HIV）感染者中的非传染性疾病（NCDs）正在出现，并且是该人群死亡的主要原因。

目的

确定HIV感染者中非传染性疾病的疾病趋势、患病率和结局。

地点

该研究在马尼卡兰省进行。

方法

我们回顾了2013年10月至2023年9月的二手数据。分析了五种优先非传染性疾病的数据：高血压（HPT）、糖尿病（DM）、慢性肾脏损伤（CKD）、癌症和慢性呼吸道疾病（CRC）。进行了Kaplan-Meier分析和Cox比例风险分析，风险和风险比以95%置信水平报告。

结果

共审查了份患者档案。中位年龄为（）岁。共有（%）为男性，（%）为女性。共有（%）的患者患有高血压，（%）患有糖尿病，（%）患有慢性肾脏损伤，（%）患有癌症，（%）患有慢性呼吸道疾病。在控制年龄、性别和药物使用情况后，接受抗逆转录病毒治疗（ART）超过5年和年龄增长是糖尿病和高血压的危险因素。基于蛋白酶抑制剂的治疗方案是糖尿病的危险因素（风险比[HR] %）。基于依非韦伦的治疗方案对高血压的发生具有保护作用（%），P = 0.01。

结论

高血压和糖尿病是HIV感染者中最常见的非传染性疾病。高血压和糖尿病的患病率随年龄和接受ART的时间增加而增加。为了尽量减少与非传染性疾病和HIV合并症相关的并发症，我们建议至少每月定期筛查非传染性疾病，并为高血压患者采用基于依非韦伦的个性化治疗方案。我们对HIV感染者进行了关于非传染性疾病风险以及健康饮食和定期锻炼重要性的教育。