Affiliations 

  • 1 Kirby Institute, UNSW Sydney, Australia
  • 2 TREAT Asia/amfAR, The Foundation for AIDS Research, Bangkok, Thailand
  • 3 National Hospital for Tropical Disease, Hanoi, Vietnam
  • 4 Hospital Sungai Buloh, Kuala Lumpur, Malaysia
  • 5 Research Institute for Tropical Medicine, Manila, Philippines
  • 6 Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand
  • 7 HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
  • 8 Bach Mai Hospital, Hanoi, Vietnam
  • 9 CART Clinical Research Site, Infectious Diseases Medical Centre, Voluntary Health Services, Chennai, India
  • 10 University Malaya Medical Centre, Kuala Lumpur, Malaysia
  • 11 Social Health Clinic, National Center for HIV/AIDS, Dermatology and STDs, Phnom Penh, Cambodia
  • 12 Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
  • 13 Udayana University and Sanglah Hospital, Denpasar, Indonesia
  • 14 Beijing Ditan Hospital, Capital Medical University, Beijing, China
  • 15 Chiangrai Prachanukhor Hospital, Chiangrai, Thailand
  • 16 Research Institute for Health Sciences, Chiangmai, Thailand
  • 17 Queen Elizabeth Hospital, Hong Kong
  • 18 BJ Government Medical College and Sassoon General Hospitals, Pune, India
  • 19 Severance Hospital, Seoul, South Korea
  • 20 Taipei Veterans General Hospital, Taipei, Taiwan
  • 21 National Center for Global Health and Medicine, Tokyo, Japan
  • 22 Tan Tock Seng Hospital, Singapore
  • 23 Vanderbilt University Medical Center, Institute for Global Health, Nashville, USA
  • 24 Institute for Implementation Science in Population Health, City University of New York, New York, USA
  • 25 Institute of Social and Preventative Medicine, University of Bern, Switzerland
  • 26 Institute for Infectious Diseases, Pune, India
J Virus Erad, 2020 Feb 20;6(1):11-18.
PMID: 32175086

Abstract

Objectives: Integration of HIV and non-communicable disease services improves the quality and efficiency of care in low- and middle-income countries (LMICs). We aimed to describe current practices for the screening and management of atherosclerotic cardiovascular disease (ASCVD) among adult HIV clinics in Asia.

Methods: Sixteen LMIC sites included in the International Epidemiology Databases to Evaluate AIDS - Asia-Pacific network were surveyed.

Results: Sites were mostly (81%) based in urban public referral hospitals. Half had protocols to assess tobacco and alcohol use. Protocols for assessing physical inactivity and obesity were in place at 31% and 38% of sites, respectively. Most sites provided educational material on ASCVD risk factors (between 56% and 75% depending on risk factors). A total of 94% reported performing routine screening for hypertension, 100% for hyperlipidaemia and 88% for diabetes. Routine ASCVD risk assessment was reported by 94% of sites. Protocols for the management of hypertension, hyperlipidaemia, diabetes, high ASCVD risk and chronic ischaemic stroke were in place at 50%, 69%, 56%, 19% and 38% of sites, respectively. Blood pressure monitoring was free for patients at 69% of sites; however, most required patients to pay some or all the costs for other ASCVD-related procedures. Medications available in the clinic or within the same facility included angiotensin-converting enzyme inhibitors (81%), statins (94%) and sulphonylureas (94%).

Conclusion: The consistent availability of clinical screening, diagnostic testing and procedures and the availability of ASCVD medications in the Asian LMIC clinics surveyed are strengths that should be leveraged to improve the implementation of cardiovascular care protocols.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.