Assessment of the Effects of Highly Active Antiretroviral Therapy on the Renal Function of Patients with HIV-1 in a Rural Setting of South Eastern Nigeria

Abstract

A study to assess the effects of Highly Active Antiretroviral Therapy on the renal function of patients with HIV-1 in a rural setting of South Eastern Nigeria was conducted. One hundred and forty seven adult patients with mean age of 31 years comprising of 65 females and 82 males were enlisted for this study. This investigation was carried in the Federal Teaching Hospital Abakaliki where the subjects were registered and placed on antiretroviral therapy and evaluated for eighteen months with respect to renal function parameters such as creatinine and urea in correlation with CD4 T-cell count. Personnel factors such as age, sex and social status were also considered. The result revealed that 42 (28%) patients showed elevated serum urea and creatinine values above normal range as indicated by mean values of 71.6mg/dl and 3.92mg/dl from initial values of 50.71mg/dl and 1.24mg/dl at baseline respectively in the 18^th month respectively the value are significant as p<0.05 and had a correlations coefficient of .975 .829 at 0.01 level with CD₄⁺ T-cell. Also the CD₄⁺ T-cell count increased from mean value of 81±16 cell/?l to 521±27 cell/?l at 18^th months. The result shows that while the antiretroviral therapy may show good prognosis when considered on the basis of CD₄⁺ T-cell turn over the impact on renal function is significantly deleterious. While the treatment of HIV infected person with anti retroviral is receiving wider attention, the side effects of these drugs are continually manifesting among some recipients especially in rural poor setting. This may not be unconnected with concomitant administration of other drugs such as antimalarial. There is therefore the need for proper monitoring of patients on antiretroviral therapy for adverse effect on renal function.

Keywords: Assessment, antiretroviral, HIV-1, creatinine, urea, CD₄⁺ T-cell.