西太平洋地区感染艾滋病毒的中老年成年人的非传染性疾病负担：系统回顾和荟萃分析

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine Pub Date : 2025-09-05 DOI:10.1016/j.ypmed.2025.108408

Hung-Chang Chou , Tsung-Yu Tsai , Huei Chung

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引用次数: 0

摘要

目的：西太平洋地区（WPR）感染艾滋病毒的中老年成年人正在经历加速老龄化和非传染性疾病（NCD）相关合并症负担的增加。本系统综述和荟萃分析旨在评估40岁及以上艾滋病毒感染者（PLWH）与艾滋病毒阴性人群的主要非传染性疾病负担（以患病率、发病率和死亡率衡量）。方法：通过Medline（1966-）、Embase（1974-）、Cochrane Library（1996-）、Epistemonikos（成立于2012年，回顾性覆盖）和Web of Science（1900-）进行全面的文献检索，找出截至2025年5月9日发表的相关研究。荟萃分析仅限于具有三个或更多可比较研究的非传染性疾病类别。采用MetaXL软件进行随机效应分析。结果：纳入了19篇文章，大多数报道了患病率估计（13/19项研究）。我们的研究结果显示，心血管疾病（1.17，[95 %置信区间：0.97-1.42]）、癌症（1.23[1.05-1.45]）、糖尿病（1.64[1.19-2.27]）、肾脏疾病（2.26[1.03-4.97]）、慢性呼吸系统疾病（2.13[0.82-5.53]）和精神疾病（2.25[1.82-2.78]）的总患病率估计。亚组分析显示抑郁症患病率明显较高（3.00[2.17-4.16]）。癌症的总发病率比为3.99(2.33-6.84)/ 1000人年。结论：在WPR中，携带艾滋病毒的中老年成年人面临癌症、糖尿病、肾脏疾病和精神健康状况的负担增加。迫切需要制定适合不同人群具体需求的护理战略，并需要进一步研究以支持慢性呼吸道疾病的管理。

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Non-communicable disease burden among middle-aged and older adults living with HIV in the Western Pacific region: A systematic review and meta-analysis

Objective

Middle-aged and older adults living with HIV in the Western Pacific Region (WPR) are experiencing accelerated aging and a rising burden of non-communicable disease (NCD)-related comorbidities. This systematic review and meta-analysis aimed to assess the burden of major NCDs—measured by prevalence, incidence, and mortality—among people living with HIV(PLWH) aged 40 years and older, in comparison to their HIV-negative counterparts.

Methods

A comprehensive literature search was conducted across Medline (1966-), Embase (1974-), Cochrane Library (1996-), Epistemonikos (established in 2012, with retrospective coverage), and Web of Science (1900-) to identify relevant studies published up to May 9, 2025. Meta-analyses limited to NCD categories with three or more comparable studies. Random-effects was performed using MetaXL software.

Results

Nineteen articles were included, and the majority reported prevalence estimates (13/19 studies). Our findings indicated pooled prevalence ratio estimates for cardiovascular diseases (1.17, [95 % confidence interval: 0.97–1.42]), cancers (1.23 [1.05–1.45]), diabetes (1.64 [1.19–2.27]), kidney diseases (2.26 [1.03–4.97]), chronic respiratory diseases (2.13 [0.82–5.53]) and mental illnesses (2.25 [1.82–2.78]). Subgroup analysis indicated a significantly high prevalence of depression (3.00 [2.17–4.16]). The pooled incident rate ratio for cancers was 3.99 (2.33–6.84) per 1000 person-years.

Conclusions

In the WPR, middle-aged and older adults living with HIV face an elevated burden of cancers, diabetes, kidney disorders, and mental health conditions. There is an urgent need to develop care strategies tailored to the specific needs of diverse populations, and further research is required to support the management of chronic respiratory diseases.

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来源期刊

Preventive medicine 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.70

自引率

3.90%

发文量

审稿时长

42 days

期刊介绍： Founded in 1972 by Ernst Wynder, Preventive Medicine is an international scholarly journal that provides prompt publication of original articles on the science and practice of disease prevention, health promotion, and public health policymaking. Preventive Medicine aims to reward innovation. It will favor insightful observational studies, thoughtful explorations of health data, unsuspected new angles for existing hypotheses, robust randomized controlled trials, and impartial systematic reviews. Preventive Medicine''s ultimate goal is to publish research that will have an impact on the work of practitioners of disease prevention and health promotion, as well as of related disciplines.