Assessment of the effect of antiretroviral therapy on renal and liver functions among HIV-infected patients: a retrospective study

Abstract

BackgroundThe emergence of highly active antiretroviral therapy (HAART) has dramatically improved quality of life in prolonging survival of human immunodeficiency virus (HIV)-infected patients on treatment in developed as well as developing countries. However, the main shortcoming of HAART in long-term use is its potential to cause liver and kidney derangements that may be life threatening. The drugs are actively accumulated in the proximal renal tubule resulting in functional disturbance with mitochondrial injury being one of the most important targets recognized. Therefore, the aim of this study was to assess the adverse effects of HAART on kidney and liver functions among HIV-infected patients presenting to the University of Gondar Hospital, Ethiopia.Materials and methodsAn institution-based retrospective study was conducted from 2010 to 2015 on a subset of HIV-infected patients. Data were collected from the registration book of the University of Gondar Hospital antiretroviral clinic laboratory after checking the completeness of age, gender, creatinine, blood urea nitrogen, and alanine aminotransferase level. Data were entered and analyzed using SPSS version 20. Descriptive statistics, chi-square test, one-way analysis of variance, and logistic regression were done to determine associations. A P-value <0.05 was considered statistically significant.ResultsA total of 275 study subjects were included in the study. Of these, 62.2% were females, and the overall prevalence of chronic kidney disease (CKD) before and after treatment was 3.6% and 11.7%, respectively. A majority of the CKD patients were in stage 3 for patients after treatment. The overall prevalence of hepatotoxicity was 6.5% and 16.7% before and after treatment, respectively. A majority of the patients developed Grade 2 hepatotoxicity 66.7% and 65.2% before and after treatment, respectively. Binary and multiple logistic regression analysis indicated that the female gender was a risk factor for CKD.ConclusionThe prevalence of nephrotoxicity and hepatotoxicity were high among patients who took HAART. Stage 3 nephrotoxicity and Grade 2 hepatotoxicity had the highest incidences of the total toxicities, and the female gender was a risk factor for nephrotoxicity. Further prospective studies are recommended to determine the effect of HAART and contributing factors.

Evaluation of hepatic and kidney dysfunction among newly diagnosed HIV patients with viral hepatitis infection in Cape Coast, Ghana

“…Even though HIV/HBV co-infected patients are at an increased risk of developing liver fibrosis compared with HIV mono-infected individual [34], our findings revealed that co-infection was independent of liver fibrosis. The prevalence of hepatotoxicity was 7.8%, which compares with the 6.5% reported in Ethiopia [35], however, the higher rate in this study could be due to the presence of co-infection with HBV.…”

“…The use of tenofovir and/or lamivudine in ART combination for treating HIV complicated with HBV co-infection has been recommended irrespective of the immune state of the patients [36]. However, these drugs have been found to increase the risk of developing nephrotoxicity in these patients [35, 37, 38]. Therefore, assessment of the renal function prior to treatment has been recommended [16, 37].…”

IgG Fc-binding motif-conjugated HIV-1 fusion inhibitor exhibits improved potency and in vivo half-life: Potential application in combination with broad neutralizing antibodies

“…It was reported that long-term use of antiretroviral therapy may cause histopathological and histomorphological changes in the liver and kidneys [28–29], and the elevated serum creatinine and alanine aminotransferase (ALT) [30]. Therefore, it is necessary to evaluate the potential in vitro and in vivo toxicity of IBP-CP24.…”

Incidence and Risk Factors of Combined-Antiretroviral Therapy-Induced Hepatotoxicity among HIV Patients at the Bali District Hospital, Cameroon

“…Many studies have been carried out in Cameroon [9,29,30] and out of Cameroon [14,15,23,[31][32][33] on hepatotoxicity but there is paucity data on HAART/ cART-inducedhepatotoxicity.…”