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. 2022 Apr;23(4):331-361.
doi: 10.1111/hiv.13240. Epub 2022 Mar 3.

Comorbidities in women living with HIV: A systematic review

Sonia Raffe  1 , Caroline Sabin  2   3 , Yvonne Gilleece  1   4 ; Women Against Viruses in Europe (WAVE), European AIDS Clinical Society
Affiliations

Comorbidities in women living with HIV: A systematic review

Sonia Raffe et al. HIV Med. 2022 Apr.

Abstract

Objectives: Effective antiretroviral therapy (ART) has improved the life expectancy of women living with HIV (WLWH). This population is now experiencing age-related comorbidities. This systematic review presents the current understanding of the prevalence and impact of comorbidities in WLWH in the modern ART era.

Methods: MEDLINE and Embase were searched for studies (1 January 2010 to 1 September 2020) reporting the prevalence of cardiovascular, bone, renal and neurocognitive disease in WLWH aged > 18 years. Studies were included if at least 100 participants (or > 50%) were female and data analysis included prevalence by sex.

Results: In all, 3050 articles were identified and screened; 153 full-text articles were assessed for eligibility and 38 were included in the final review. Significant gaps in the literature were identified, notably a lack of data on WLWH aged > 50 years. The data suggest a high burden of cardiovascular, bone, renal and neurocognitive disease in WLWH compared with HIV negative women. Traditional risk factors, such as hypertension, diabetes and dyslipidaemia, were common and often poorly managed. Generalizability of the results was limited, as many studies were conducted in the USA. Comparisons between WLWH and men with HIV were limited by marked differences in demographic and socioeconomic factors.

Conclusions: Women living with HIV experience a high burden of comorbid disease. Traditional risk factors are common and often poorly managed. This review also highlights the magnitude of differences between women and men living with HIV beyond the pathophysiological. Future research must unpick the complex drivers of morbidity in WLWH, to improve the holistic management of this population.

Keywords: HIV; ageing; comorbidities; review; women.

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Conflict of interest statement

CS has received funding for membership of Data Safety and Monitoring Boards and Advisory Boards, and for preparation of educational materials from Gilead Sciences, ViiV Healthcare and Janssen‐Cilag. YG has received funding for membership of Advisory Boards and for preparation of educational materials from Gilead Sciences, ViiV Healthcare and Janssen‐Cilag.

Figures

FIGURE 1
FIGURE 1
Flow chart of study selection process
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