The incidence of cardiovascular disease, cancer and type 2 diabetes comorbidities in HIV infection: A systematic review

Abstract

Introduction: Epidemiological linkages between HIV/AIDS and common Noncommunicable diseases are established. However, the incidence of these diseases among people living with HIV is not well examined. Objectives: To describe the incidence of cardiovascular diseases, cancers, and type 2 diabetes among people living with HIV. Methods: We have conducted a systematic review of incidence studies. Studies reporting on the incidence of cardio- vascular diseases, cancers and type 2 diabetes among People living with HIV were retrieved from Embase and Medline databases. We used explicit eligibility and quality appraisal criteria to screen and select studies. We extracted study characteristics, outcome values and key conclusions. Findings were reported using tables and narrative summaries. Results: A total of 30 studies were included in this systematic review. The incidence of cardiovascular diseases, cancers, and type 2 Diabetes comorbidities among people living with HIV was found to range from 1.19 to 11.3, 6.63 to 43.77, and 4.42 to 36.26 per 1000 person years, respectively. HIV infection was associated with increased risk of cardiovascular diseases and cancers. Specific types of antiretroviral drugs and longer duration of antiretroviral treatment were among the determinants of cardiovascular diseases and type 2 Diabetes in HIV infection. While the introduction of antiretroviral treatment was followed by a rapid decline in the incidence of AIDS-defining cancers, its effect on the incidence of non-AIDS defining cancers looks minimal. Conclusion: The current evidence suggests that policies and interventions targeting people living with HIV should prioritize the prevention of the risk of common Noncommunicable diseases together with the rapid scale up of HIV treatment.