Non‐communicable diseases among elderly patients with human immunodeficiency virus infection at an urban clinic in a resource‐limited setting

Abstract

Purpose of the studyFollowing the introduction of highly‐active antiretroviral therapy (HAART), there is improved survival of elderly persons infected with HIV, which may be complicated by multiple co‐morbidities. There is limited data on non‐communicable disease prevalence among HIV‐infected elderly persons in developing countries. The objective of the study was to estimate the prevalence of diabetes mellitus, hypertension and obesity among HIV‐infected elderly persons above 60 years of age attending an urban clinic in Kampala, Uganda.MethodsWe retrospectively reviewed records from a program perspective of HIV‐infected patients aged 60 years of age and above who were attending our clinic. The purpose was to assess prevalence of non‐communicable diseases to improve clinical care.Summary of resultsDuring the period from April 2011 to March 2012 we reviewed records and identified 154 HIV‐infected patients aged 60 years of age and above. Of these, 26 (16.9%) were aged 70 years and older while 128 (83.1%) were 60–69 years of age. The median age was 63 years (IQR: 61–68 years). Eighty‐five (55.2%) were males while 69 (44.8%) were females. Only 10 participants (6.5%) had been diagnosed with diabetes mellitus while 42 participants (27.3%) had essential hypertension. On the contrary, only 6 patients (4%) had both essential hypertension and diabetes mellitus. There was evidence to show that 58.3% of the female participants with a BMI≥25.00 kg/m2 were significantly different from 38.7% of their male counterparts with a BMI of ≥25.00 kg/m2 (χ2=5.16; 1 df; p=0.02). There was strong evidence that hypertensive patients with BMI <25.00 kg/m2 were significantly different from hypertensive patients with BMI ≥25.00 kg/m2 (χ2=9.55; 1 df; p=0.002).ConclusionThree in 10 elderly HIV positive persons aged 60 years and older had a non‐communicable disease‐either diabetes mellitus or essential hypertension. Thirty‐one percent of patients were either overweight or obese. Almost 50% of patients were diabetic, hypertensive, overweight or obese. There is therefore need to incorporate diagnostic tests and management protocols of non‐communicable disease control for elderly HIV‐positive persons aged 60 years and older in resource‐limited settings.