HIV/AIDS and Coronary Heart Disease on a Collision Course? Review of Zimbabwe

Abstract

here are very few published manuscripts on coronary heart disease (CHD) from Sub-Saharan Africa (SSA) and Zimbabwe. In fact the few published papers on the subject suggest that CHD is rare in SSA and in Zimbabwean individuals both before HIV and in the era of HIV/AIDS and antiretroviral therapy (ART). However a look at recent literature and data from publications by both the World Health Organization (WHO) and Zimbabwe Ministry of Health and Child Care point towards an epidemiological transition, as CHD is now one of the top causes of death in Zimbabwe. This may be due to the fact that CHD is a complex inflammatory disease involving smoking, obesity, diabetes, atherogenic lipid levels, cytokines and other inflammatory markers such as C reactive protein (CRP) and myeloperoxidase (MPO) and many of these factors have consistently been linked to changing lifestyle as populations move into urban settings. On the other hand, atherogenic lipids and elevated inflammatory markers are more common in HIV infected individuals due to the virus and ART. Hence it is likely that the burden of non-communicable diseases (NCDs) and CHD will increase over time as a result of both urbanization in the general population and a high HIV disease burden in Zimbabwe, pointing towards a collision of HIV and CHD in future.