HIV and Non-Communicable Diseases: A Growing Public Health Concern

Written by Dr. Vaishnavi Ganesh Adhav Dr. Vaishnavi Ganesh Adhav is a skilled healthcare professional with a Bachelor of Dental Surgery (BDS) from Maharashtra University of Health Sciences and an internship from Government Dental College. She further pursued her master’s degree at MIT World Peace University (MIT-WPU), graduating with distinction and earning a gold medal for academic excellence. With four years of industry experience, Dr. Vaishnavi has made significant contributions not only in clinical dentistry but also in the fields of women’s empowerment and Non-Communicable Diseases (NCDs). Her dedication to healthcare, coupled with her involvement in social impact initiatives, reflects her commitment to improving public health and empowering communities.

Human Immunodeficiency Virus (HIV) has transformed from a fatal disease to a manageable chronic condition thanks to advances in antiretroviral therapy (ART). However, with increased life expectancy among people living with HIV (PLHIV), the burden of non-communicable diseases (NCDs) such as diabetes, cardiovascular diseases, cancer, osteoporosis, and hypertension has risen significantly. Addressing these comorbidities is essential for improving the quality of life and long-term outcomes for PLHIV.

Globally, an estimated 38.4 million people were living with HIV in 2021, with 1.5 million new infections reported that year (UNAIDS, 2022). In India, approximately 2.4 million individuals are living with HIV, making it the third-largest epidemic in the world (NACO, 2022). Alongside this, NCDs are responsible for 74% of all deaths globally, with cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases being the leading causes (WHO, 2022). Notably, PLHIV are at a higher risk of developing NCDs compared to the general population due to factors like chronic inflammation and ART-related side effects.

In India, NCDs account for nearly 65% of all deaths, and PLHIV are disproportionately affected. Studies indicate that around 30%-40% of PLHIV in India are diagnosed with at least one NCD, such as diabetes or cardiovascular diseases (NACO, 2022). This growing dual burden of HIV and NCDs underscores the importance of integrated healthcare approaches to ensure better health outcomes for these individuals.

HIV and Non-Communicable Diseases: Understanding the Connection

PLHIV are at a higher risk of developing NCDs due to a combination of factors such as chronic inflammation, side effects of long-term ART, aging, and lifestyle-related changes. These conditions, including diabetes, cardiovascular diseases, cancer, and osteoporosis, demand integrated care to address the overlapping challenges of managing HIV and NCDs.

The Impact of Antiretroviral Therapy on NCD Risk Factors

While ART has been a lifesaver for millions, some medications, particularly protease inhibitors, are linked to metabolic changes, such as insulin resistance, dyslipidemia, weight gain, and decreased bone mineral density. Additionally, chronic inflammation caused by HIV infection itself contributes to the development of cardiovascular diseases, osteoporosis, and other NCDs. Regular monitoring and early intervention are crucial to mitigating these risks.

Managing NCDs in HIV Patients: A Holistic Approach

1. Dietary Considerations A balanced diet plays a crucial role in managing HIV and NCDs. Specific dietary recommendations include:
   • For diabetes: High-fiber, low-glycemic-index foods.
   • For cardiovascular health: Reducing saturated fats, trans fats, and sodium intake.
   • For osteoporosis: Including calcium and vitamin D-rich foods like dairy products, leafy greens, and fortified cereals.
   • For overall wellness: Incorporating whole grains, fruits, vegetables, and lean proteins.
2. Exercise for HIV and NCDs Regular physical activity benefits PLHIV by improving cardiovascular health, enhancing insulin sensitivity, strengthening bones, and reducing stress. Activities such as walking, swimming, yoga, and resistance training are particularly beneficial and adaptable for individuals with varying fitness levels.
3. Lifestyle Changes for HIV and NCDs
   • Avoiding tobacco and limiting alcohol consumption, both of which exacerbate bone loss and cardiovascular risks.
   • Prioritizing mental health to manage stress effectively.
   • Maintaining adherence to medication routines for both HIV and NCD management.

Recognizing NCD Symptoms in PLHIV

The symptoms of NCDs, such as fatigue, chest pain, persistent cough, increased thirst, and bone pain, may overlap with general HIV-related complications. Early detection through regular screenings is critical for effective management. For instance:

• Diabetes: Increased thirst, frequent urination, and unexplained weight loss.
• Cardiovascular diseases: Shortness of breath, chest pain, and high blood pressure.
• Cancer: Unexplained weight loss, fatigue, or abnormal growths.
• Osteoporosis: Bone pain, fragility fractures, and noticeable shrinking in height due to compression of spinal vertebrae.

Taal Healthcare: Pioneering Integrated Care for HIV and NCDs

Taal Healthcare stands at the forefront of addressing the complex healthcare needs of PLHIV. As a trusted provider, Taal Healthcare specializes in combining HIV treatment with comprehensive NCD management. Their holistic approach ensures patients receive:

• Personalized Treatment Plans: Tailored care strategies that address both HIV and co-existing NCDs, such as diabetes, cardiovascular diseases, and osteoporosis.
• Regular Screenings: Routine evaluations for blood sugar levels, lipid profiles, bone density, and other critical markers.
• Counseling and Education: Empowering patients with knowledge about lifestyle changes, diet modifications, and exercise routines that support overall health.
• Advanced Diagnostics and Monitoring: Utilizing state-of-the-art technologies to track disease progression and treatment effectiveness.

Taal Healthcare’s dedicated team of specialists ensures that PLHIV not only manage their condition effectively but also lead healthier, more fulfilling lives. Through integrated care models, Taal Healthcare exemplifies how addressing the dual burden of HIV and NCDs can lead to better outcomes and enhanced patient satisfaction.

Prevention and Control of HIV and NCDs

Prevention and Control of HIV AIDS

Comprehensive strategies for the prevention of HIV transmission include:

• Consistent use of condoms.
• Pre-exposure prophylaxis (PrEP) for high-risk individuals.
• Routine testing and prompt initiation of ART.

Integrated NCD Prevention

• Encouraging regular health check-ups.
• Promoting a balanced diet and active lifestyle.
• Raising awareness about the early signs and symptoms of NCDs for timely intervention.

Integrated Care: The Path Forward

The dual burden of HIV and NCDs highlights the need for integrated care models that:

• Combine HIV treatment with NCD screening and management.
• Educate patients on the importance of regular follow-ups and lifestyle modifications.
• Promote research into cost-effective interventions for prevention and control of HIV AIDS and associated NCDs.

Conclusion

The interplay between HIV and NCDs such as diabetes, cardiovascular diseases, cancer, and osteoporosis underscores the need for holistic healthcare solutions. By focusing on prevention, early diagnosis, and integrated management, we can improve the quality of life for PLHIV while addressing the dual burden of HIV and NCDs. With organizations like Taal Healthcare leading the charge, the future of comprehensive care for PLHIV is promising, marked by innovation, compassion, and dedication.