Thokozani SB Maseko and Sakhile KS Masuku
Diabetes mellitus and hypertension [DM] are among the major causes of morbidity and mortality among people living with human immunodeficiency virus [PLHIV]. Diabetes mellitus alone is associated with morbidities that consequently reduce life expectancy and quality of life, and causes demoralising complications inclusive of ischaemic heart disease, stroke, blindness and peripheral vascular disease. Hypertension is an important and treatable cause of cardiovascular morbidity and mortality. It is an independent risk factor for myocardial infarction, chronic kidney disease ischemic and haemorrhagic stroke, heart failure and premature death. HIV infection is associated with morbidities that consequently reduce life expectancy and quality of life. There is a perceived link between HIV infection and DM and hypertension. This is a scoop review of studies on the link between HIV and DM and hypertension, that is, both epidemiologic and biological evidence to date. The literature review shows that the incidence and prevalence of type 2 diabetes [T2DM] is higher among PLHIV on ART compared to the HIV negative population. Being infected by human immunodeficiency virus (HIV) is implied to trigger an inflammatory response that, in turn, results in insulin resistance, a risk for T2DM. HIV is linked to hypertension through alterations in triglycerides, T cells and angiotensin II as well as the aggressive use of ART. The roll out of antiretroviral therapy (ART), as means to combat HIV, has benefits for PLHIV, inclusive of increased survival and living longer; yet older age is associated with hypertension and T2DM. The side effects of ART and long term use of ART are implicated in increasing the risk of T2DM among PLHIV. The co-occurrence of HIV, hypertension and T2DM in developing countries presents an overload to the burden of diseases because these countries are already experiencing high prevalence rates of HIV thereby complicating the health status of the population. Notwithstanding the contrasting research reports on the link between HIV, hypertension and DM hypertension and DM among PLHIV is a cause for concern, and there is a need for more studies, particularly in areas most hit by HIV.