The Effects of HAART on the Renal Functions of HIV Positive Patients in Nsukka, South East Nigeria

Abstract

Background: Renal failure is highly prevalent among persons with Human Immuno Deficiency virus (HIV) infection and is linked to high morbidity and mortality rate. Aim: The aim of this study was to determine the effect of HIV infection on CD4+ cells, urea and creatinine of HIV patients that are being treated with Combivir N for a period of 8 months. Study Design: Forty three male and female HIV positive subjects ready to be placed on Highly Active Antiretroviral Therapy (HAART) (Combivir N) and 20 non HIV positive subjects were randomly selected and CD4+ cells, urea and creatinine levels of HIV positive subjects were determined before treatment, 4 months and 8 months into treatment. Methodology: Flow cytometry using partec cyflow machine was used in analyzing the CD4+ cells, serum urea  was determined by Berthelot‘s method, while creatinine was measured by Bartels and Bohmer method. Results: Mean cell level of CD4+ count was higher in 8 months of treatment (319.02 ± 138.68) than before treatment and 4 months into treatment (246.51 ± 71.30 and 310.04 ± 106.60) but lower than control group (1023. 01 ± 203.03). Mean serum level of urea was higher in 4 months into treatment (35.51 ± 13.92) than before treatment and control group (27.14 ± 11.06 and 14.71 ± 3.80). Also mean serum level of creatinine was higher in 4 months into treatment (1.30 ± 0.53) than 8 months into treatment and control subjects (0.98 ± 0.31 and 0.93 ± 0.12). In this study serum levels of urea were significantly correlated with creatinine level (p < .001). Conclusion: The commencement of HAART for the study population led to an increase in their CD4+ count. The levels of the renal markers creatinine and urea, showed a picture of an initial derangement but an attempt towards recovery by the system. These effects are indicative of a positive prognosis with regard to HIV/AIDS infection which resulted from the initiation of HAART (Combivir N).