Prevalence and incidence of pulmonary hypertension among HIV-infected people in Africa: a systematic review and meta-analysis

Bigna, Jean Joel R., Nansseu, Jobert Richie N., Um, Lewis N., Noumegni, Steve Raoul N., Sime, Paule Sandra D., Aminde, Leopold Ndemngue, Koulla-Shiro, Sinata and Noubiap, Jean Jacques N. (2016) Prevalence and incidence of pulmonary hypertension among HIV-infected people in Africa: a systematic review and meta-analysis. BMJ Open, 6 8: e011921. doi:10.1136/bmjopen-2016-011921


Author Bigna, Jean Joel R.
Nansseu, Jobert Richie N.
Um, Lewis N.
Noumegni, Steve Raoul N.
Sime, Paule Sandra D.
Aminde, Leopold Ndemngue
Koulla-Shiro, Sinata
Noubiap, Jean Jacques N.
Title Prevalence and incidence of pulmonary hypertension among HIV-infected people in Africa: a systematic review and meta-analysis
Journal name BMJ Open   Check publisher's open access policy
ISSN 2044-6055
2044-6055
Publication date 2016-08-23
Year available 2016
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1136/bmjopen-2016-011921
Open Access Status DOI
Volume 6
Issue 8
Start page e011921
Total pages 7
Place of publication London, United Kingdom
Publisher B M J Group
Language eng
Subject 2700 Medicine
Abstract OBJECTIVE: Patients infected with HIV have a direly increased risk of developing pulmonary hypertension (PH), and of dying from the condition. While Africa carries the greatest burden of HIV infection worldwide, there is unclear data summarising the epidemiology of PH among HIV-infected people in this region. Our objective was to determine the prevalence and incidence of PH among HIV-infected people living across Africa.
Formatted abstract
Objective Patients infected with HIV have a direly increased risk of developing pulmonary hypertension (PH), and of dying from the condition. While Africa carries the greatest burden of HIV infection worldwide, there is unclear data summarising the epidemiology of PH among HIV-infected people in this region. Our objective was to determine the prevalence and incidence of PH among HIV-infected people living across Africa.

Design A systematic review and meta-analysis.

Participants HIV-infected African people residing in Africa.

Outcome Prevalence and incidence of PH diagnosed through echocardiography or right heart catheterisation.

Data sources Articles published in PubMed/MEDLINE, EMBASE, African Journals Online and African Index Medicus between 1 January 1980 and 30 June 2016, without any language restriction.

Results Overall, 121 studies were screened; 3 were included in this review: 1 from Southern Africa (South Africa), 1 from Eastern Africa (Tanzania) and 1 from Central Africa (Cameroon). These studies included HIV-infected adult patients selected based on presentation with cardiovascular symptoms. No study reported PH incidence or PH incidence/prevalence among children and adolescents. The quality assessment yielded moderate risk of bias. Ages of participants ranged between 18 and 78 years, and the proportion of females varied between 52.3% and 68.8%. The prevalence of PH in the pooled sample of 664 patients was 14% (95% CI 6%–23%).

Limitations Only 3 studies were found eligible from 3 regions of the African continent.

Conclusions The prevalence of PH among HIV-infected people in Africa seems very high. Further studies are urgently warranted to determine the incidence of HIV-induced PH, which must include all subregions of Africa.

Trial registration number Review registration number PROSPERO CRD42016033863.
Keyword Africa
AIDS
HIV
Pulmonary arterial hypertension
Pulmonary hypertension
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: HERDC Pre-Audit
School of Public Health Publications
 
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Created: Wed, 07 Sep 2016, 20:13:37 EST by Leopold Aminde on behalf of School of Medicine