Non-communicable diseases among people living with HIV, Victoria Chitepo provincial hospital: A retrospective cohort study, a secondary data analysis (2013-2023)

Abstract

Background Non-communicable diseases (NCDs) associated with human immunodeficiency virus (HIV) are emerging as the leading cause of death globally. An in depth analysis of the burden of NCDs in Manicaland province has not been done. We analyzed the NCDs/HIV data at Victoria Chitepo provincial hospital. Methods We conducted a retrospective cohort study from October 2013 to September 2023 using secondary data. Five major groups of NCDs were selected which were hypertension (HPT), diabetes mellitus (DM), chronic kidney injury (CKD), cancers and chronic respiratory illness. Kaplan Meier analysis and Cox proportional hazard analysis were performed. Risk ratios and hazard ratios with 95% confidence intervals were generated. Results A total of 974 patient records were reviewed with a median age of 43 (Q₁₌35; Q₃ = 51) years. Number of years on antiretroviral therapy (ART) (HR = 5.99, 95% CI: p < 0.001), age (HR = 4.78, 95%CI: p < 0.001) and DM/HIV comorbidity (HR = 4.63, 95% CI: p < 0.001) were hazards to HPT while being on efavirenz based regimen had a lower risk (HR = 0.47, 95% CI: p = 0.01) of developing HPT. Number of years on ART (HR = 9.89, 95% CI: p < 0.001), being on PI based regimen (HR = 4.66, 95% CI: p < 0.001), age (HR = 3.86, 95% CI, p < 0.001) and being on WHO stage 3 or 4 (HR = 3.75, 95% CI: p < 0.001) were hazards to DM. In 2022, the prevalence rate was 12 per 1000 people per year. Conclusion HPT and DM are the common NCDs among people living with HIV in this cohort. To minimize complications related to NCD/HIV comorbidities, we recommend routine screening of NCDs at monthly basis for early diagnosis and treatment.