HIV/AIDS: Research and Palliative Care (Sep 2023)
Management of Type 2 Diabetes Mellitus and Kidney Failure in People with HIV-Infection in Africa: Current Status and a Call to Action
Abstract
Nicola Wearne,1 Bianca Davidson,1 Marc Blockman,2 Jackie Jones,3 Ian L Ross,4 Joel A Dave4 1Division of Nephrology and Hypertension, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa; 2Division of Clinical Pharmacology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa; 3Medicines Information Centre, Division of Clinical Pharmacology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; 4Division of Endocrinology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South AfricaCorrespondence: Joel A Dave, Division of Endocrinology, Department of Medicine, G13, G-Floor, Groote Schuur Hospital, Observatory, Cape Town, 7925, South Africa, Tel +27 21 4042135, Email [email protected]: There is an increasing global burden of diabetes mellitus (DM) and chronic kidney disease (CKD), coupled with a high burden of people with HIV (PWH). Due to an increased lifespan on ART, PWH are now at risk of developing non-communicable diseases, including DM. Africa has the greatest burden of HIV infection and will experience the greatest increase in prevalence of DM over the next two decades. In addition, there is a rising number of people with CKD and progression to kidney failure. Therefore, there is an urgent need for the early identification and management of all 3 diseases to prevent disease progression and complications. This is particularly important in Africa for people with CKD where there is restricted or no access to dialysis and/or transplantation. This review focuses on the epidemiology and pathophysiology of the interaction between HIV infection and DM and the impact that these diseases have on the development and progression of CKD. Finally, it also aims to review the data on the management, which stems from the growing burden of all three diseases.Keywords: chronic kidney disease, renal replacement therapy, antiretroviral therapy, Diabetes mellitus
