Three-quarters of people on antiretroviral treatment at a clinic in Khayelitsha were also being treated for hypertension. Yet there is not enough information about how HIV and common NCDs such as hypertension and diabetes interact, or how medicines to treat them interact.

This is according to Dr Tolu Oni from the University of Cape Town, who is investigating the “collision” between HIV and NCDs.

“As people living with HIV are living longer, we are facing a new challenge. NCDs pose a new threat to people with HIV but there are many unanswered questions,” Oni told the international AIDS conference.

These questions include the extent of NCD co-infection, medicine interactions and how to co-diagnose and co-treat these.

Fattest nation

Aside from having the largest HIV population in the world, South Africa is the fattest nation on the continent.

Up to 70% of South African women and a third of men are overweight or obese, while a quarter of girls and one in five boys between the ages of 2 and 14 years are overweight or obese. Obesity is associated with type 2 diabetes, heart disease, stroke, hypertension, joint pain and certain cancers.

“Some NCDS are related to HIV infection itself and to the side effects of some of the medicines used to treat HIV infection,” according to UNAIDS. “Several of the opportunistic illnesses associated with HIV infection are NCDs in their own right, such as HIV-associated lymphoma and cervical cancer.”

Australian Professor Andrew Grulich reported that “the pattern of cancer and HIV is beginning to collide” as the population of people with HIV ages.

“There is an exponential increase in cancer as a person ages,” said Grulich.

A skin cancer called Kaposi’s Sarcoma was common in people with low immunity, but could be treated once a person was on ARVs. However, lymphoma was the most common cancer in people with HIV with mildly suppressed immunity, he said.

Californian epidemiologist Dr Melissa Frasco reported that two classes of ARVs were associated with an increase in diabetes, while “untreated HIV could lead to metabolic syndrome” (including obesity), which put patients at risk of heart attacks and strokes.

Supporting this, a Kenyan study has shown that HIV positive people who were not on treatment had significantly higher rates of hypertension than HIV negative people.

“Ageing with HIV is a huge issue in Europe, where people started ARV treatment earlier. Addressing this needs both a medical and psycho-social approach,” said Tamas Bereczky, who is both living with HIV and a researcher with the European AIDS Treatment Group. – Health-e News.