HIV and noncommunicable diseases: the Asian perspective

J Acquir Immune Defic Syndr. 2014 Sep 1:67 Suppl 1:S99-103. doi: 10.1097/QAI.0000000000000262.

Abstract

Asia is seeing a rise in noncommunicable diseases in their general population and among people living with HIV. Many Asians have low body weight, which can lead to higher plasma concentrations of antiretrovirals and, as a result, their toxicities. Examples are metabolic complications from protease inhibitors, chronic kidney disease from tenofovir, and hepatotoxicity from nevirapine. Asia has not only the highest burden of hepatitis B viral infection than any other continent but also a predominance of genotypes B and C, the latter associated with higher risk for hepatocellular carcinoma. HIV-associated neurocognitive disorders are equally common among Asians as other populations. Diastolic dysfunction and asymptomatic myocardial ischemia are not infrequent. Non-Hodgkin lymphoma is the most common AIDS-related cancer, whereas Kaposi sarcoma is relatively infrequent. Emerging data show high prevalence of human papillomavirus-associated anal dysplasia in men who have sex with men. Resource-limited countries in Asia suffer from lack of resources for national screening programs of noncommunicable diseases, which, in turn, limits the epidemiologic data that exist to guide the use of national health resources.

Publication types

  • Review

MeSH terms

  • AIDS Dementia Complex / epidemiology
  • AIDS-Associated Nephropathy / epidemiology
  • Anti-Retroviral Agents / adverse effects
  • Anti-Retroviral Agents / therapeutic use
  • Asia / epidemiology
  • Comorbidity
  • Developing Countries
  • Drug-Related Side Effects and Adverse Reactions / epidemiology
  • HIV Infections / complications*
  • HIV Infections / epidemiology*
  • HIV-Associated Lipodystrophy Syndrome / epidemiology
  • Hepatitis B, Chronic / epidemiology
  • Humans
  • Neoplasms / epidemiology
  • Papillomavirus Infections / epidemiology

Substances

  • Anti-Retroviral Agents