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Trans R Soc Trop Med Hyg. 2015 Jul;109(7):440-6. doi: 10.1093/trstmh/trv038. Epub 2015 May 21.

HIV with non-communicable diseases in primary care in Kibera, Nairobi, Kenya: characteristics and outcomes 2010-2013.

Author information

1
Médecins Sans Frontières, Nairobi, Kenya jeffreykedwards@gmail.com.
2
Médecins Sans Frontières, Southern Africa Medical Unit, Cape Town, South Africa.
3
Medical Department, Luxembourg Operational Research Unit, Operational Center Brussels, Médecins Sans Frontières, Brussels, Belgium.
4
Médecins Sans Frontières, Nairobi, Kenya.
5
University of Nairobi, Department of Obstetrics and Gynaecology, Nairobi, Kenya.
6
Kenya National AIDs and STI Control Program/HRH Capacity Bridge Project, Nairobi, Kenya.

Abstract

BACKGROUND:

Antiretroviral therapy (ART) has increased the life expectancy of people living with HIV (PLHIV); HIV is now considered a chronic disease. Non-communicable diseases (NCDs) and HIV care were integrated into primary care clinics operated within the informal settlement of Kibera, Nairobi, Kenya. We describe early cohort outcomes among PLHIV and HIV-negative patients, both of whom had NCDs.

METHODS:

A retrospective analysis was performed of routinely collected clinic data from January 2010 to June 2013. All patients >14 years with hypertension and/or diabetes were included.

RESULTS:

Of 2206 patients included in the analysis, 210 (9.5%) were PLHIV. Median age at enrollment in the NCD program was 43 years for PLHIV and 49 years for HIV-negative patients (p<0.0001). The median duration of follow up was 1.4 (IQR 0.7-2.1) and 1.0 (IQR 0.4-1.8) years for PLHIV and HIV-negative patients, respectively (p=0.003). Among patients with hypertension, blood pressure outcomes were similar, and for those with diabetes, outcomes for HbA1c, fasting glucose and cholesterol were not significantly different between the two groups. The frequency of chronic kidney disease (CKD) was 12% overall. Median age for PLHIV and CKD was 50 vs 55 years for those without HIV (p=0.005).

CONCLUSIONS:

In this early comparison of PLHIV and HIV-negative patients with NCDs, there were significant differences in age at diagnosis but both groups responded similarly to treatment. This study suggests that integrating NCD care for PLHIV along with HIV-negative patients is feasible and achieves similar results.

KEYWORDS:

Africa; Chronic kidney disease; Diabetes; HIV; Hypertension; Non-communicable diseases

PMID:
25997923
DOI:
10.1093/trstmh/trv038
[Indexed for MEDLINE]

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