Hepatitis B Virus and Tuberculosis Are Associated with Increased Noncommunicable Disease Risk among Treatment-Naïve People with HIV: Opportunities for Prevention, Early Detection and Management of Comorbidities in Sierra Leone
Noncommunicable diseases (NCDs) are a growing public health concern in low- and middle-income countries and disproportionately affect people living with HIV (PWH). Hepatitis B virus (HBV) and tuberculosis (TB) coinfection are presumed risk factors in endemic settings; however, supporting evidence is...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/12/3466 |
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| author | George A. Yendewa Sulaiman Lakoh Darlinda F. Jiba Sahr A. Yendewa Umu Barrie Gibrilla F. Deen Mohamed Samai Jeffrey M. Jacobson Foday Sahr Robert A. Salata |
| author_facet | George A. Yendewa Sulaiman Lakoh Darlinda F. Jiba Sahr A. Yendewa Umu Barrie Gibrilla F. Deen Mohamed Samai Jeffrey M. Jacobson Foday Sahr Robert A. Salata |
| author_sort | George A. Yendewa |
| collection | DOAJ |
| description | Noncommunicable diseases (NCDs) are a growing public health concern in low- and middle-income countries and disproportionately affect people living with HIV (PWH). Hepatitis B virus (HBV) and tuberculosis (TB) coinfection are presumed risk factors in endemic settings; however, supporting evidence is conflicting. We analyzed baseline data of newly diagnosed PWH prospectively enrolled in the Sierra Leone HIV Cohort Study in Freetown, Sierra Leone, from March to September 2021. Logistic regression was used to identify associations between NCDs, HBV and TB. A total of 275 PWH aged ≥18 years were studied (55% female, median age 33 years, median CD4 307 cells/mm<sup>3</sup>, 15.3% HIV/HBV, 8.7% HIV/TB). NCDs were bimodally distributed, with 1 in 4 PWH clustered around liver disease (fibrosis/cirrhosis), diabetes/prediabetes and obesity/preobesity, while 1 in 8 had renal impairment or hypertension (HTN). Overall, 41.5% had ≥1 NCD, while 17.5% were multimorbid (≥2 NCDs). After adjusting for age, sex, sociodemographic factors and CD4 count, liver fibrosis/cirrhosis was strongly associated with HBV (aOR 8.80, 95% CI [2.46–31.45]; <i>p</i> < 0.001) and diabetes/prediabetes (aOR 9.89, 95% CI [1.14–85.67]; <i>p</i> < 0.037). TB independently predicted diabetes/prediabetes (aOR 7.34, 95% CI [1.87–28.74]; <i>p</i> < 0.004), while renal impairment was associated with proteinuria (aOR 9.34, 95% CI [2.01–43.78]; <i>p</i> < 0.004) and HTN (aOR 6.00, 95% CI [1.10–35.39]; <i>p</i> < 0.049). Our findings warrant the implementation of NCD-aware HIV programs for the prevention, early detection and management of comorbidities. |
| first_indexed | 2024-03-09T23:27:21Z |
| format | Article |
| id | doaj.art-7486f86d65d84d9da5512bc876172b25 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T23:27:21Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-7486f86d65d84d9da5512bc876172b252023-11-23T17:16:33ZengMDPI AGJournal of Clinical Medicine2077-03832022-06-011112346610.3390/jcm11123466Hepatitis B Virus and Tuberculosis Are Associated with Increased Noncommunicable Disease Risk among Treatment-Naïve People with HIV: Opportunities for Prevention, Early Detection and Management of Comorbidities in Sierra LeoneGeorge A. Yendewa0Sulaiman Lakoh1Darlinda F. Jiba2Sahr A. Yendewa3Umu Barrie4Gibrilla F. Deen5Mohamed Samai6Jeffrey M. Jacobson7Foday Sahr8Robert A. Salata9Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USADepartment of Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra LeoneMinistry of Health and Sanitation, Freetown, Sierra LeoneMinistry of Health and Sanitation, Freetown, Sierra LeoneInfectious Disease Research Network, Freetown, Sierra LeoneDepartment of Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra LeoneDepartment of Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra LeoneDepartment of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USADepartment of Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra LeoneDepartment of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USANoncommunicable diseases (NCDs) are a growing public health concern in low- and middle-income countries and disproportionately affect people living with HIV (PWH). Hepatitis B virus (HBV) and tuberculosis (TB) coinfection are presumed risk factors in endemic settings; however, supporting evidence is conflicting. We analyzed baseline data of newly diagnosed PWH prospectively enrolled in the Sierra Leone HIV Cohort Study in Freetown, Sierra Leone, from March to September 2021. Logistic regression was used to identify associations between NCDs, HBV and TB. A total of 275 PWH aged ≥18 years were studied (55% female, median age 33 years, median CD4 307 cells/mm<sup>3</sup>, 15.3% HIV/HBV, 8.7% HIV/TB). NCDs were bimodally distributed, with 1 in 4 PWH clustered around liver disease (fibrosis/cirrhosis), diabetes/prediabetes and obesity/preobesity, while 1 in 8 had renal impairment or hypertension (HTN). Overall, 41.5% had ≥1 NCD, while 17.5% were multimorbid (≥2 NCDs). After adjusting for age, sex, sociodemographic factors and CD4 count, liver fibrosis/cirrhosis was strongly associated with HBV (aOR 8.80, 95% CI [2.46–31.45]; <i>p</i> < 0.001) and diabetes/prediabetes (aOR 9.89, 95% CI [1.14–85.67]; <i>p</i> < 0.037). TB independently predicted diabetes/prediabetes (aOR 7.34, 95% CI [1.87–28.74]; <i>p</i> < 0.004), while renal impairment was associated with proteinuria (aOR 9.34, 95% CI [2.01–43.78]; <i>p</i> < 0.004) and HTN (aOR 6.00, 95% CI [1.10–35.39]; <i>p</i> < 0.049). Our findings warrant the implementation of NCD-aware HIV programs for the prevention, early detection and management of comorbidities.https://www.mdpi.com/2077-0383/11/12/3466HIVHBVtuberculosisnoncommunicable diseasesSierra Leone |
| spellingShingle | George A. Yendewa Sulaiman Lakoh Darlinda F. Jiba Sahr A. Yendewa Umu Barrie Gibrilla F. Deen Mohamed Samai Jeffrey M. Jacobson Foday Sahr Robert A. Salata Hepatitis B Virus and Tuberculosis Are Associated with Increased Noncommunicable Disease Risk among Treatment-Naïve People with HIV: Opportunities for Prevention, Early Detection and Management of Comorbidities in Sierra Leone Journal of Clinical Medicine HIV HBV tuberculosis noncommunicable diseases Sierra Leone |
| title | Hepatitis B Virus and Tuberculosis Are Associated with Increased Noncommunicable Disease Risk among Treatment-Naïve People with HIV: Opportunities for Prevention, Early Detection and Management of Comorbidities in Sierra Leone |
| title_full | Hepatitis B Virus and Tuberculosis Are Associated with Increased Noncommunicable Disease Risk among Treatment-Naïve People with HIV: Opportunities for Prevention, Early Detection and Management of Comorbidities in Sierra Leone |
| title_fullStr | Hepatitis B Virus and Tuberculosis Are Associated with Increased Noncommunicable Disease Risk among Treatment-Naïve People with HIV: Opportunities for Prevention, Early Detection and Management of Comorbidities in Sierra Leone |
| title_full_unstemmed | Hepatitis B Virus and Tuberculosis Are Associated with Increased Noncommunicable Disease Risk among Treatment-Naïve People with HIV: Opportunities for Prevention, Early Detection and Management of Comorbidities in Sierra Leone |
| title_short | Hepatitis B Virus and Tuberculosis Are Associated with Increased Noncommunicable Disease Risk among Treatment-Naïve People with HIV: Opportunities for Prevention, Early Detection and Management of Comorbidities in Sierra Leone |
| title_sort | hepatitis b virus and tuberculosis are associated with increased noncommunicable disease risk among treatment naive people with hiv opportunities for prevention early detection and management of comorbidities in sierra leone |
| topic | HIV HBV tuberculosis noncommunicable diseases Sierra Leone |
| url | https://www.mdpi.com/2077-0383/11/12/3466 |
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