Assessment of Renal Function among HIV-Infected Patients on Combination Antiretroviral Therapy at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

Abstract

Background: Acquired immunodeficiency syndrome (AIDS) is a spectrum of disease states characterized by progressive immunosuppression. Sub-Saharan Africa is heavily affected by human immunodeficiency virus (HIV) and AIDS than any other region of the world. Renal complications are important component of advanced HIV disease, and these complications significantly contribute to morbidity and mortality in HIV/AIDS patients. Aim of the Study: To assess renal function abnormalities in HIV infected patients and compare with treatment-naive and HIV-negative control groups. Methods: A retrospective cross sectional study of comparative nature was designed and samples and biochemical data were collected from July 1/2012 to February 1/2013 in patients attending the ART clinic at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Renal functions of 180 participants were assessed. The data obtained were analyzed using SPSS version 16.0. Result: A total of 180 participants grouped as HIV-negative controls (n = 60), HIV+ treatment-naive (n = 60) and HIV+ on HAART were recruited to participate in this study. Out of 180 participants included in the study, 59 (32.78%) were males and the remaining 121 (67.22%) were females. Mean serum total protein was higher in patients on HAART groups (5.78 ± 1.39) than treatment-naive (4.76 ± 2.19). There was significant reduction (p < 0.05) in serum total protein in both HIV+ groups as compared with the control groups. The mean serum creatinine level was not significantly different among three groups. The mean serum creatinine clearance in treatment-naive groups (111.05 ± 11.33) was lower than the control groups (115.05 ± 44.41) and patients on HAART (114.76 ± 28.54). There was a positive and significant correlation of glomerular filtration rate with BMI on treatment-naive groups. Conclusion: There are no statistically significant differences in the levels of Creatinine clearance and Estimated Glomerular Filtration Rate (eGFR) in HIV positive patients (naive as well as treated) as compared to the negative controls. The prevalence of renal impairment as defined by CrCl < 60 mL/min (eGFR < 60 ml/min/1.73 m 2 ) is higher in treatment-naive participants than those on HAART and HIV-negative control groups.