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Review
. 2018 May 23:2018:6916497.
doi: 10.1155/2018/6916497. eCollection 2018.

Prevalence, Risk Factors, and Pathophysiology of Dysglycemia among People Living with HIV in Sub-Saharan Africa

Benson Njuguna  1 , Jepchirchir Kiplagat  2 , Gerald S Bloomfield  3 , Sonak D Pastakia  4 , Rajesh Vedanthan  5 , John R Koethe  6
Affiliations
Review

Prevalence, Risk Factors, and Pathophysiology of Dysglycemia among People Living with HIV in Sub-Saharan Africa

Benson Njuguna et al. J Diabetes Res. .

Abstract

Objective: To review available literature on the prevalence, risk factors, pathophysiology, and clinical outcomes of dysglycemia among people living with HIV (PLHIV) in sub-Saharan Africa (SSA).

Methods: Database search on PUBMED for eligible studies describing the prevalence, risk factors, pathophysiology, or clinical outcomes of dysglycemia in SSA PLHIV.

Results: Prevalence of diabetes mellitus (DM) and pre-DM among SSA PLHIV ranged from 1% to 26% and 19% to 47%, respectively, in 15 identified studies. Older age and an elevated body mass index (BMI) were common risk factors for dysglycemia. Risk factors potentially more specific to PLHIV in SSA included exposure to older-generation thymidine analogues or protease inhibitors, malnutrition at ART initiation, a failure to gain fat mass on treatment, and elevated serum lipids. There is evidence of higher nephropathy and neuropathy rates among PLHIV in SSA with comorbid DM compared to HIV-negative individuals with DM.

Conclusion: There is a need for longitudinal studies to enhance understanding of the risk factors for dysglycemia among PLHIV in SSA, further research into optimal therapies to reduce pre-DM progression to DM among SSA PLHIV, and studies of the burden and phenotype of diabetic complications and other health outcomes among PLHIV with comorbid DM in SSA.

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Figures

Figure 1
Figure 1
Prevalence of diabetes mellitus (DM) and prediabetes (pre-DM) in HIV-infected patients.
Figure 2
Figure 2
Summary of factors associated with prevalent or incident diabetes in studies of PLHIV from sub-Saharan Africa.
See this image and copyright information in PMC

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