Abstract
Background and Objectives: HIV has been a serious global health concern since its discovery, with about 37.9 million people living with HIV worldwide as of 2018. Sub-Saharan Africa (SSA) accounts for 68% of the infection and contributed 74% of the 1.5 million deaths in 2013 despite having only 12% of the total world population residing in the region. This systematic review has attempted to determine the association between heavy metal toxicity and the occurrence of non-communicable diseases in the HIV/AIDS population. Materials and Methods: Three databases were systematically searched: PubMed, Scopus, and Google Scholar for studies written in English and published between 1 April 2000 and 12 April 2020. Studies were excluded if the main outcomes were not measured or did not meet the inclusion criteria. Results: All the six included studies are cross-sectional in design, and therefore were evaluated using the STROBE checklist. The data extraction was done using an extraction table; the ratio of female to male participants included in the study was 1.09:1. Qualitative analysis was used due to the heterogeneity in the heavy metal biomarkers and the outcome measured by the included studies. Two studies compared the concentration of heavy metals in HIV-positive and HIV-negative participants while one compared the levels between HAART-naïve and HAART-treated participants, and three determined the association between heavy metal toxicity and non-communicable diseases (liver fibrosis, anaemia, and reproductive parameters, respectively) in HIV-positive patients. Conclusions: Blood lead, cadmium, and mercury levels were higher in HIV-seropositive than -seronegative subjects, whereas serum zinc level was lower in HIV-seropositive than -seronegative subjects, but the causal association between heavy metals and non-communicable diseases in HIV subjects is largely unknown. Interdisciplinary research between nutrition, toxicology, and human health is envisaged for primary and secondary prevention and treatment.
Highlights
Human immunodeficiency virus (HIV), since its discovery, has been a serious global health concern [1]
Many inflammatory markers have been studied in association with clinically evident cardiovascular disease (CVD) and carotid intima-media thickness (CIMT) in HIV-infected patients to ascertain increased cardiovascular risk observed in HIV infection [10]
The studies independently measured the concentration of heavy metal biomarkers in HIVTphaetsietundtsi.eTswinodoepf ethnedaernttilcylems emaasduereadctohme cpoanricseonntroaftitohne ocof nhceeanvtyramtieotnalobfihoemaavrykmerestianls HinIVHpIaVt-ipenostsit.iTvwe wo iotfhtHheIVa-rntiecgleastimveadpearaticcoipmapnatsr,iswohniolef ttwheocaornticcelenstrcaotmionpaorfehdehaevayvmy metaeltsal inleHveIVls-bpeotswiteivene wHiAthAHRTIV-n-anïevgeaatinvdeHpaArAticRiTp-atnretas,tewdhpilaerttiwciopaanrttisc,laens dcotmwpoasrteuddiheesawveyrme deotanle leivnetlhsebHetIwVepeonpHulAatAioRnTw-niathïvoeutacnodntHroAlsA
Summary
Human immunodeficiency virus (HIV), since its discovery, has been a serious global health concern [1]. Ongoing studies have established the presence of comorbidities associated with chronic HIV infection: HIV-associated CVD [11], HIV-associated renal and genitourinary diseases [5], HIV-associated malignancies [12], HIV-associated non-Hodgkin lymphoma (NHL) [13], HIV-associated endocrine dysfunction [14], and HIV-associated pulmonary diseases [4] These comorbidities lead to avoidable, untimely death that blunts the health gains attained in HIV-infected populations [6]. This systematic review has attempted to determine the association between heavy metal toxicity and the occurrence of non-communicable diseases in the HIV/AIDS population. Interdisciplinary research between nutrition, toxicology, and human health is envisaged for primary and secondary prevention and treatment
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