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An Emerging Syndemic of Smoking and Cardiopulmonary Diseases in People Living with HIV in Africa

Background: African countries have the highest number of people living with HIV (PWH). The continent is home to 12% of the global population, but accounts for 71% of PWH globally. Antiretroviral therapy has played an important role in the reduction of the morbidity and mortality rates for HIV, which...

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Autores principales: Peprah, Emmanuel, Armstrong-Hough, Mari, Cook, Stephanie H., Mukasa, Barbara, Taylor, Jacquelyn Y., Xu, Huichun, Chang, Linda, Gyamfi, Joyce, Ryan, Nessa, Ojo, Temitope, Snyder, Anya, Iwelunmor, Juliet, Ezechi, Oliver, Iyegbe, Conrad, O’Reilly, Paul, Pascal Kengne, Andre
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8003038/
https://www.ncbi.nlm.nih.gov/pubmed/33803504
http://dx.doi.org/10.3390/ijerph18063111
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author Peprah, Emmanuel
Armstrong-Hough, Mari
Cook, Stephanie H.
Mukasa, Barbara
Taylor, Jacquelyn Y.
Xu, Huichun
Chang, Linda
Gyamfi, Joyce
Ryan, Nessa
Ojo, Temitope
Snyder, Anya
Iwelunmor, Juliet
Ezechi, Oliver
Iyegbe, Conrad
O’Reilly, Paul
Pascal Kengne, Andre
author_facet Peprah, Emmanuel
Armstrong-Hough, Mari
Cook, Stephanie H.
Mukasa, Barbara
Taylor, Jacquelyn Y.
Xu, Huichun
Chang, Linda
Gyamfi, Joyce
Ryan, Nessa
Ojo, Temitope
Snyder, Anya
Iwelunmor, Juliet
Ezechi, Oliver
Iyegbe, Conrad
O’Reilly, Paul
Pascal Kengne, Andre
author_sort Peprah, Emmanuel
collection PubMed
description Background: African countries have the highest number of people living with HIV (PWH). The continent is home to 12% of the global population, but accounts for 71% of PWH globally. Antiretroviral therapy has played an important role in the reduction of the morbidity and mortality rates for HIV, which necessitates increased surveillance of the threats from pernicious risks to which PWH who live longer remain exposed. This includes cardiopulmonary comorbidities, which pose significant public health and economic challenges. A significant contributor to the cardiopulmonary comorbidities is tobacco smoking. Indeed, globally, PWH have a 2–4-fold higher utilization of tobacco compared to the general population, leading to endothelial dysfunction and atherogenesis that result in cardiopulmonary diseases, such as chronic obstructive pulmonary disease and coronary artery disease. In the context of PWH, we discuss (1) the current trends in cigarette smoking and (2) the lack of geographically relevant data on the cardiopulmonary conditions associated with smoking; we then review (3) the current evidence on chronic inflammation induced by smoking and the potential pathways for cardiopulmonary disease and (4) the multifactorial nature of the syndemic of smoking, HIV, and cardiopulmonary diseases. This commentary calls for a major, multi-setting cohort study using a syndemics framework to assess cardiopulmonary disease outcomes among PWH who smoke. Conclusion: We call for a parallel program of implementation research to promote the adoption of evidence-based interventions, which could improve health outcomes for PWH with cardiopulmonary diseases and address the health inequities experienced by PWH in African countries.
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spelling pubmed-80030382021-03-28 An Emerging Syndemic of Smoking and Cardiopulmonary Diseases in People Living with HIV in Africa Peprah, Emmanuel Armstrong-Hough, Mari Cook, Stephanie H. Mukasa, Barbara Taylor, Jacquelyn Y. Xu, Huichun Chang, Linda Gyamfi, Joyce Ryan, Nessa Ojo, Temitope Snyder, Anya Iwelunmor, Juliet Ezechi, Oliver Iyegbe, Conrad O’Reilly, Paul Pascal Kengne, Andre Int J Environ Res Public Health Commentary Background: African countries have the highest number of people living with HIV (PWH). The continent is home to 12% of the global population, but accounts for 71% of PWH globally. Antiretroviral therapy has played an important role in the reduction of the morbidity and mortality rates for HIV, which necessitates increased surveillance of the threats from pernicious risks to which PWH who live longer remain exposed. This includes cardiopulmonary comorbidities, which pose significant public health and economic challenges. A significant contributor to the cardiopulmonary comorbidities is tobacco smoking. Indeed, globally, PWH have a 2–4-fold higher utilization of tobacco compared to the general population, leading to endothelial dysfunction and atherogenesis that result in cardiopulmonary diseases, such as chronic obstructive pulmonary disease and coronary artery disease. In the context of PWH, we discuss (1) the current trends in cigarette smoking and (2) the lack of geographically relevant data on the cardiopulmonary conditions associated with smoking; we then review (3) the current evidence on chronic inflammation induced by smoking and the potential pathways for cardiopulmonary disease and (4) the multifactorial nature of the syndemic of smoking, HIV, and cardiopulmonary diseases. This commentary calls for a major, multi-setting cohort study using a syndemics framework to assess cardiopulmonary disease outcomes among PWH who smoke. Conclusion: We call for a parallel program of implementation research to promote the adoption of evidence-based interventions, which could improve health outcomes for PWH with cardiopulmonary diseases and address the health inequities experienced by PWH in African countries. MDPI 2021-03-18 /pmc/articles/PMC8003038/ /pubmed/33803504 http://dx.doi.org/10.3390/ijerph18063111 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Commentary
Peprah, Emmanuel
Armstrong-Hough, Mari
Cook, Stephanie H.
Mukasa, Barbara
Taylor, Jacquelyn Y.
Xu, Huichun
Chang, Linda
Gyamfi, Joyce
Ryan, Nessa
Ojo, Temitope
Snyder, Anya
Iwelunmor, Juliet
Ezechi, Oliver
Iyegbe, Conrad
O’Reilly, Paul
Pascal Kengne, Andre
An Emerging Syndemic of Smoking and Cardiopulmonary Diseases in People Living with HIV in Africa
title An Emerging Syndemic of Smoking and Cardiopulmonary Diseases in People Living with HIV in Africa
title_full An Emerging Syndemic of Smoking and Cardiopulmonary Diseases in People Living with HIV in Africa
title_fullStr An Emerging Syndemic of Smoking and Cardiopulmonary Diseases in People Living with HIV in Africa
title_full_unstemmed An Emerging Syndemic of Smoking and Cardiopulmonary Diseases in People Living with HIV in Africa
title_short An Emerging Syndemic of Smoking and Cardiopulmonary Diseases in People Living with HIV in Africa
title_sort emerging syndemic of smoking and cardiopulmonary diseases in people living with hiv in africa
topic Commentary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8003038/
https://www.ncbi.nlm.nih.gov/pubmed/33803504
http://dx.doi.org/10.3390/ijerph18063111
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