A Baseline Studies on the Nutritional Interplay between HIV Drugs and Kidney, Liver and Heart Indices in Patients Receiving HIV Treatment in North-East Nigeria

Abstract

Human Immunodeficiency Virus (HIV) patients on Antiretroviral Therapy (ART) have shown impressive improvement and death rates have drastically reduced, even though complications still exist. This research carried out a baseline stud y to determine the nutritional interplay between HIV-drugs and kidney, liver, and heart indices among subjects undergoing HIV treatment and attending the Medical Out-Patient Department of a Federal Medical Center in the North - Eastern part of Nigeria, using a sample size of 50 individuals both male and female, who have been shown to be HIV positive and have been on ART for over 12 months. Anthropometric data was collect ed in triplicate, two from patients ’ file, and one was measured directly and the average was obtained. The electrolytes were determined by the colorimetric method while total protein and albumin in blood concentration were determined by spectrophotometric method, but globulin and A/G ratio were determined by calculation. TC was determined using Spectrophotometric method while HDL was determined after precipitation of LDL with phosphotungstate and magnesium w ere calculated from Friedwaldís formular, and TG was measured using the colorimetric enzymatic method. The results showed that the mean systolic and diastolic blood pressure which were 119.9 mmHg ± 17.5, and 76. 6 mmHg ± 10.1 respectively, were with the range of the reference values. The mean body mass index was 25.1 ± 4.9; also within range of the reference value. Major indices from the liver function test were mean ALT which was 36.5 ± 29.4 with a reference value of 7 - 55 U/L; AST was 40.0 ± 32.3, with a reference value of 8 - 48 U/L. The mean value for albumin was 4.6 ± 7.1 with a reference range of 3.5 - 5.0 g/dl, these values also were within the reference range values. The electrolyte test showed all other electrolyte s to be within the reference range values except for Zinc which was 19.5 μmol/L, with a normal range of 70 - 100 μmol/L and magnesium which was found to be 0.7 mEq/L, with a normal range of 1.5 - 2.0 mEq/L; Zinc and magnesium play vital roles in over 300 enzymatic reactions, and are known to be important in the immune response. Shortfalls in these minerals could compromise the patients’ recovery process and place them at risk of hearts conditions such as arrhyth mia or heart attack among many other conditions. There is a need for an immediate review of these treatments in the direction of Zinc and magnesium, either by supplementation or by diet therapy. HIV patients undergoing ART should be placed under strict Zinc and magnesium - rich diet to avert untimely death among these patients. The controlled study should be done to ascertain the best approach to quell the residue of malnutrition in these patients in order to further improve their nutritional status.