BIOCHEMICAL EVALUATION OF THE HEPATIC AND KIDNEY FUNCTIONS IN PATIENTS UNDERGOING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY AT THE BAFOUSSAM REGIONAL HOSPITAL, CAMEROON

Abstract

Background: Nowadays, one of the main ways to manage HIV infection is the use of highly active antiretroviral therapy (HAART). Despite the benefit associated with the use of antiretrovirals, these could have side effects on certain vital body functions such as the liver and kidneys.
 Aim of the Study: The main objective of this study was to assess the liver and kidney functions of people living with HIV (PLWHIV) and undergoing highly active antiretroviral therapy at the Bafoussam Regional Hospital (BRH).
 Methodology: A cross-sectional study was conducted for three months on 100 HIV-positive patients undergoing HAART at the Regional Hospital of Bafoussam. Sociodemographic, clinical and biological data were recorded for each subject and then analyzed using standard procedures. Liver function was explored by the following biochemical parameters: alanine aminotransferase, aspartate aminotransferase, albumin, total and direct bilirubin. The renal function was explored by measuring the creatinine and the serum uric acid levels. Results: Among the 100 patients who participated in the study, 83 were women (83 %) and 17 patients were men (17 %). The most represented age group was between 41 and 50 years old (37 %). The mean age was 47.66 ± 10.2 years. For the liver function assessment, 6 % had elevated alanine aminotransferase activity (greater than 42 IU/L), 8 % had an increase in the aspartate aminotransferase activity (greater than 38 IU/L) and 17% of patients had hypoalbuminemia (below 35 g/L). In addition, 14% of the patients had a high total bilirubin level (greater than 1 mg/dL) and 62% of the patients had a high direct bilirubin level (greater than 0.3 mg/dL). Patients presenting simultaneously an abnormal level of direct and total bilirubin were following the Zidovudine-Lamivudine-Atazan avir-Ritonavir (ZLAR) second line regimen. For the evaluation of renal function, 18% had a high creatinine level (greater than 14 mg/L) and 24% of patients had an abnormal level of uric acid (greater than 60 mg/L), this variation was not associated with antiretroviral treatment (p > 0.05).
 Conclusion: No significant association was found between the regimen and the variations of certain biochemical parameters. However, compared to ZLAR, Tenofovir-Lamivudine-Dolutegravir (TLD) was the regimen that recorded the largest number of patients with abnormal variations of biochemical parameters involved in this study.