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Editorial
. 2020 Feb 20;6(1):11-18.
doi: 10.1016/S2055-6640(20)30005-4.

Atherosclerotic cardiovascular disease screening and management protocols among adult HIV clinics in Asia

D C Boettiger  1   2 , M G Law  1 , J Ross  3 , B V Huy  4 , Bsl Heng  5 , R Ditangco  6 , S Kiertiburanakul  7 , A Avihingsanon  8 , D D Cuong  9 , N Kumarasamy  10 , A Kamarulzaman  11 , P S Ly  12 , E Yunihastuti  13 , T Parwati Merati  14 , F Zhang  15 , S Khusuwan  16 , R Chaiwarith  17 , M P Lee  18 , S Sangle  19 , J Y Choi  20 , W W Ku  21 , J Tanuma  22 , O T Ng  23 , A H Sohn  3 , C W Wester  24 , D Nash  25   26 , C Mugglin  27 , S Pujari  28
Affiliations
Editorial

Atherosclerotic cardiovascular disease screening and management protocols among adult HIV clinics in Asia

D C Boettiger et al. J Virus Erad. .

Abstract

Objectives: Integration of HIV and non-communicable disease services improves the quality and efficiency of care in low- and middle-income countries (LMICs). We aimed to describe current practices for the screening and management of atherosclerotic cardiovascular disease (ASCVD) among adult HIV clinics in Asia.

Methods: Sixteen LMIC sites included in the International Epidemiology Databases to Evaluate AIDS - Asia-Pacific network were surveyed.

Results: Sites were mostly (81%) based in urban public referral hospitals. Half had protocols to assess tobacco and alcohol use. Protocols for assessing physical inactivity and obesity were in place at 31% and 38% of sites, respectively. Most sites provided educational material on ASCVD risk factors (between 56% and 75% depending on risk factors). A total of 94% reported performing routine screening for hypertension, 100% for hyperlipidaemia and 88% for diabetes. Routine ASCVD risk assessment was reported by 94% of sites. Protocols for the management of hypertension, hyperlipidaemia, diabetes, high ASCVD risk and chronic ischaemic stroke were in place at 50%, 69%, 56%, 19% and 38% of sites, respectively. Blood pressure monitoring was free for patients at 69% of sites; however, most required patients to pay some or all the costs for other ASCVD-related procedures. Medications available in the clinic or within the same facility included angiotensin-converting enzyme inhibitors (81%), statins (94%) and sulphonylureas (94%).

Conclusion: The consistent availability of clinical screening, diagnostic testing and procedures and the availability of ASCVD medications in the Asian LMIC clinics surveyed are strengths that should be leveraged to improve the implementation of cardiovascular care protocols.

Keywords: Asia; HIV; atherosclerosis; cardiovascular disease; hypertension.

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