HAART, DOTS and Renal Disease of Patients Co-Infected with HIV/AIDS and TB in the South West Region of Cameroon

Tuberculosis is the commonest infection among HIV/AIDS patients. This co-infection constitutes a major death threat in the world. There is paucity of data about renal disease amongst patients on HAART and DOTS therapy in Cameroon.

This was a hospital-based cross-sectional study in the Buea, Limbe and Kumba government Hospitals. Spectrophotometric method was used for the quantitative determination of serum creatinine, urea, albumin and total protein levels. Glomerular filtration rate was estimated using the MDRD method. The student’s t test, ANOVA and logistic regression were used to analyse the data.

Out of 200 participants, 101 (50.5 %) were males. The ages ranged from 21 to 65 years with a mean age of 38.04 ± 10.52 years. Compared to adults on DOTS alone, adults on HAART alone had a significantly higher prevalence of eGFR <60 ml/min/1.73 m ² while more participants on HAART/DOTS had significantly higher serum creatinine (18/60 (30 %) vs 10/70 (14.3) OR = 2.57 [1.08–6.12], p = 0.033). Though participants on HAART/DOTS combined therapy had low eGFR, the association was not statistically significant (OR = 6.27, 95 % CI;0.71–55.27, p = 0.098). Participants on the Zidovudine, Lamivudine, Nevirapine regimen showed a statistically significant difference in the mean serum creatinine and albumin levels between the HAART/DOTS combined therapy and HAART group (p = 0.0219 and 0.0001 respectively).

Compared to adults on DOTS, adults on HAART were more likely to have renal dysfunction (eGFR <60 ml/min per 1.73 m ² ). Adult on a combination of HAART and DOTS had a similar prevalence of renal dysfunction as those on HAART alone. This study showed that the use of the HAART regimen (Tenofovir, Lamivudine and Efavirenz combination) among the HAART treated adults was nephrotoxic. However, other combined HAART and DOTS regimens had no nephrotoxic effect. Abnormal kidney function can be associated with HAART use.

Full article at:  http://goo.gl/ZVtGGq

By: Dickson Shey Nsagha^1*, Benjamin Thumamo Pokam², Jules Clement Nguedia Assob²,Anna Longdoh Njunda², Odette Dzemo Kibu², Elvis Asangbeng Tanue², Charlotte Wenze Ayima² and Patrick Elroy Weledji³

¹Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea, Cameroon

²Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, Buea, Cameroon

³Department of Surgery, Obstetrics and Gynaecology, Faculty of Health Sciences, University of Buea, Buea, Cameroon

  

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