Abstract
BackgroundHuman immunodeficiency virus (HIV) infection and its treatment cause renal diseases. Renal disease is associated with an increasing cause of morbidity and mortality in HIV positive individuals than in the general population. It has been also associated with adverse outcomes, such as complications of decreased renal functions and progression to renal failure.ObjectiveTo determine the prevalence and factors associated with renal function impairment among highly active antiretroviral therapy (HAART) naive and HAART experienced adult HIV positive individuals.MethodsA facility based comparative cross-sectional study was conducted in Jimma University Specialized Hospital (JUSH) from June to September 2014. HIV positive individuals who visited JUSH during the study period were included in the study. Sociodemographic and clinical data were collected using a structured questionnaire. Blood specimen was analyzed for renal function tests. Descriptive statistics, Mann-Whitney U test and logistic regression analysis were done using SPSS version 16 software.ResultsA total of 446 HIV positive individuals, 223 HAART naïve and 223 HAART experienced, were recruited. The overall prevalence of renal function impairment was 18.2% [95%CI: 14.6–21.7]. The prevalence of renal impairment in HAART naive and HAART experienced persons was 28.7% [95%CI: 23.1–34.4] and 7.6% [95%CI: 4.6–11.6], respectively. Age ≥ 50 years (AOR = 3.6; 95% CI 1.4, 9.6), advanced WHO stage (AOR = 2.3; 95% CI 1.1, 4.7), and CD4 count <200 (AOR = 6.9; 95% CI 3.3, 14.2) were independent risk factors among HAART naive participants. Female gender (AOR = 6.6; 95 CI % 1.2, 34), age ≥ 50 years (AOR = 12.1; 95% CI 1.7, 84) and CD4 count <200 (AOR = 17; 95% CI 5.2, 58) were independent risk factors among HAART experienced participants.ConclusionThe prevalence of renal function impairment was higher among HAART naïve than HAART experienced HIV positive individuals. Renal function impairment was associated with disease advancement and old age.
Highlights
Human Immunodeficiency virus (HIV) affects every organ system in the body by direct damage or by rendering the host susceptible to opportunistic infections [1]
The prevalence of renal function impairment was higher among highly active antiretroviral therapy (HAART) naïve than HAART experienced Human immunodeficiency virus (HIV) positive individuals
Kidney involvement is seen frequently during the course of HIV infection and it has become fourth leading condition contributing to death among those who have progressed to acquired immunodeficiency syndrome (AIDS) patients after sepsis, pneumonia, and liver disease [3]
Summary
Human Immunodeficiency virus (HIV) affects every organ system in the body by direct damage or by rendering the host susceptible to opportunistic infections [1]. Kidney involvement is seen frequently during the course of HIV infection and it has become fourth leading condition contributing to death among those who have progressed to acquired immunodeficiency syndrome (AIDS) patients after sepsis, pneumonia, and liver disease [3]. This can result from common complications of the disease like dehydration and sepsis or effects of nephrotoxic drugs commonly used in the management of AIDS [4]. It has been associated with adverse outcomes, such as complications of decreased renal functions and progression to renal failure
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