Abstract
Background: Management of HIV involves a life-long administration of a cocktail of antiretroviral drugs, some of which have been known for their nephrotoxicity. Despite the increasing access to this combination therapy, Highly Active Antiretroviral Therapy (HAART) information on its renal effect is still scarce and contradictory. The aim of this study was to assess the effect of HAART on the renal function of HIV-infected patients attending the Bamenda Regional Hospital, Cameroon. Methods: This was a comparative hospital-based cross-sectional study involving HIV positive and negative individuals who visited the Day clinic of the Bamenda Regional Hospital during the study period. Spectrophotometry was used to quantify the renal markers. Glomerular Filtration Rate was determined by the 24 hours creatinine clearance method. Blood urea nitrogen was calculated from serum urea concentrations. Renal impairment was then classified according to the National Kidney Foundation clinical practice guideline. Data were analysed on SPSS version 21 using Student t-test, ANOVA, and Pearson’s correlation. The level of significance was set at p<0.05. Results: A total of 201 participants were enrolled in this study, of which 144(71.6%) were females. Their ages ranged between 22 to 60 years with a mean age of 37.4 ± 9.6 years. The participants were divided into 3 study groups; HIV negative, HAART-naïve and the HAART experienced groups. The HAART experienced group had a significantly higher mean BUN and BUN-Creatinine ratio (p= 0.001 and 0.003 respectively) as well as the least creatinine clearance (p= 0.017) when compared to the other groups meanwhile the HAART-naive group had a significantly higher mean urine protein (p= 0.026) when compared to the other two categories. There was no association between renal dysfunction and the HAART regimen as well as adherence to treatment. Conclusion: This study demonstrated that though the participants on HAART had decreased renal function, the mean Creatinine clearance was not statistically different from that of the participants not yet on HAART. this is indicative that the decreased renal function could be as a result of the devastating effect of HIV. It further demonstrates no association between decreased renal function to the type of HAART regimen used, duration on HAART as well as the patient’s adherence to treatment.
Highlights
Management of Human Immunodeficiency Virus (HIV) involves a life-long administration of a cocktail of antiretroviral drugs, some of which have been known for their nephrotoxicity
This study demonstrated that though the participants on Highly Active Antiretroviral Therapy (HAART) had decreased renal function, the mean Creatinine clearance was not statistically different from that of the participants not yet on HAART. this is indicative that the decreased renal function could be as a result of the devastating effect of HIV
This study demonstrated that HAART is associated with decreased creatinine clearance, increased blood urea nitrogen and blood urea nitrogen to creatinine ratio
Summary
Management of HIV involves a life-long administration of a cocktail of antiretroviral drugs, some of which have been known for their nephrotoxicity. Since the introduction of Highly Active Antiretroviral Therapy (HAART), a combination of at least three antiretroviral drugs from two different drug classes in the management of HIV/AIDS in the mid-1990s, there has been a drastic drop in the number of AIDS-related deaths [5, 6]. The use of these antiretroviral drugs has been reported to be associated with a number of adverse effects including those affecting the kidney [7]. HAART which involves a cocktail of antiretroviral drugs may increase the risk of kidney damage which could either be due to drug-drug interaction or the nephrotoxicity of the drugs themselves [9]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
