Comorbidities in Women Living With HIV

A Systematic Review

Sonia Raffe; Caroline Sabin; Yvonne Gilleece


HIV Medicine. 2022;23(4):331-361. 

In This Article


Search Strategy and Study Selection

We conducted a systematic literature search of MEDLINE and Embase for cohort, case–control and cross-sectional studies published from 1 January 2010 to 1 September 2020 (Appendix 1 for data sources and search terms). We also screened reference lists from relevant articles. One reviewer (SR) screened all identified titles and abstracts for studies presenting data on the prevalence of cardiovascular, bone, renal and neurocognitive disease. The remaining studies were reviewed for eligibility, with all authors agreeing on the final studies for inclusion.

Only original articles of human studies published in the English language were included. In acknowledgment of global discrepancies in access to HIV and wider medical care, only studies based in resource-rich settings were included. Studies of women under the age of 18 were excluded, as were studies primarily reporting on the outcomes of pregnancy in WLWH.

A minimum of 100 female participants were required for a study to be included or, in the case of smaller studies, at least 50% of the participants needed to be women. Studies containing both men and women were only included if data disaggregated by sex were presented. Studies were evaluated to avoid duplication of data from the same participants in multiple studies, with the most recent or comprehensive study selected for inclusion for each outcome. We excluded reviews, comments and letters. Our systematic review follows the recommendations from the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement (Appendix 2 for PRISMA checklist).

Quality Assessment and Data Extraction

Extracted data included author, year of publication, geographical location, number of study participants, number/proportion of female participants, mean age, study design, measures/definitions used, relevant risk association examined for, variables adjusted for and major findings (predominately prevalence of a comorbidity, incidence of new diagnosis of comorbidity ± hazard or risk ratio or relative risk). Quality and risk of bias were assessed using the Newcastle-Ottawa scale.