Renal Function in Ghanaian HIV-Infected Patients on Highly Active Antiretroviral Therapy: A Case-Control Study
Identifieur interne : 000663 ( Ncbi/Curation ); précédent : 000662; suivant : 000664Renal Function in Ghanaian HIV-Infected Patients on Highly Active Antiretroviral Therapy: A Case-Control Study
Auteurs : Christian Obirikorang [Ghana] ; Derick Nii Mensah Osakunor [Ghana] ; Benedict Ntaadu [Ghana] ; Opei Kwafo Adarkwa [Ghana]Source :
- PLoS ONE [ 1932-6203 ] ; 2014.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Démographie, Femelle, Ghana, Humains, Infections à VIH (physiopathologie), Infections à VIH (sang), Infections à VIH (traitement médicamenteux), Jeune adulte, Mâle, Numération des lymphocytes CD4, Statistique non paramétrique, Tests de la fonction rénale, Thérapie antirétrovirale hautement active, Électrolytes (sang), Études cas-témoins.
- MESH :
- physiopathologie : Infections à VIH.
- sang : Infections à VIH, Électrolytes.
- traitement médicamenteux : Infections à VIH.
- Adulte, Adulte d'âge moyen, Démographie, Femelle, Ghana, Humains, Jeune adulte, Mâle, Numération des lymphocytes CD4, Statistique non paramétrique, Tests de la fonction rénale, Thérapie antirétrovirale hautement active, Études cas-témoins.
- Wicri :
- geographic : Ghana.
English descriptors
- KwdEn :
- Adult, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Case-Control Studies, Demography, Electrolytes (blood), Female, Ghana, HIV Infections (blood), HIV Infections (drug therapy), HIV Infections (physiopathology), Humans, Kidney Function Tests, Male, Middle Aged, Statistics, Nonparametric, Young Adult.
- MESH :
- chemical , blood : Electrolytes.
- geographic : Ghana.
- blood : HIV Infections.
- drug therapy : HIV Infections.
- physiopathology : HIV Infections.
- Adult, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Case-Control Studies, Demography, Female, Humans, Kidney Function Tests, Male, Middle Aged, Statistics, Nonparametric, Young Adult.
Abstract
HAART is anticipated to result in an increase in long-term survival, but may present with the development of associated complications. The aim of this study was to assess the renal function of HIV-infected patients on antiretroviral therapy.
A case-control study (January to May 2013) conducted at the Suntreso Government Hospital, Kumasi, Ghana. A total of 163 HIV-infected patients (mean age 39.9±10.22) were studied, of which 111 were on HAART (HIV-HAART) and 52 were not (HIV-Controls). Serum urea, creatinine, potassium, sodium, chloride and CD4 counts were measured with the determination of eGFR (CKD-EPI and MDRD). Data was analysed using GraphPad Prism. The Chi-square, t-test, one-way ANOVA and Spearman's correlation were used.
Mean CD4 count of HIV-Controls was higher than that of HIV-HAART but was not significant (p = 0.304). But for sodium levels which were higher in HIV-Controls (p = 0.0284), urea (p = 0.1209), creatinine (p = 0.7155), potassium (p = 0.454) and chloride (p = 0.6282) levels did not differ significantly between both groups. All serum biochemical parameters did not differ significantly, irrespective of duration on therapy and CD4 counts. Based on regimen, sodium, chloride, urea and creatinine did not differ significantly between TDF, EVF and NVP-based therapies. Prevalence of CKD (eGFR <60 ml/min/1.73 m2) in the total population was 9.9% and 3.7% with the MDRD and EPI-CKD equations respectively.
Renal insufficiency remains prevalent in HIV patients. Changes in renal function occur in HIV infection and over the course of HAART but the difference at either stage is not significant. This suggests the role of HIV infection, HAART and the presence of traditional risk factors but not HAART in itself, in renal dysfunction. We however recommend a close monitoring of patients before and during HAART, to aid in evaluating drug combinations and implement dose modifications when necessary.
Url:
DOI: 10.1371/journal.pone.0099469
PubMed: 24921259
PubMed Central: 4055675
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wicri:curation="lc">Ghana</country><wicri:regionArea>Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital (KATH), Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Antiretroviral Therapy, Highly Active</term><term>CD4 Lymphocyte Count</term><term>Case-Control Studies</term><term>Demography</term><term>Electrolytes (blood)</term><term>Female</term><term>Ghana</term><term>HIV Infections (blood)</term><term>HIV Infections (drug therapy)</term><term>HIV Infections (physiopathology)</term><term>Humans</term><term>Kidney Function Tests</term><term>Male</term><term>Middle Aged</term><term>Statistics, Nonparametric</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Démographie</term><term>Femelle</term><term>Ghana</term><term>Humains</term><term>Infections à VIH (physiopathologie)</term><term>Infections à VIH (sang)</term><term>Infections à VIH (traitement médicamenteux)</term><term>Jeune adulte</term><term>Mâle</term><term>Numération des lymphocytes CD4</term><term>Statistique non paramétrique</term><term>Tests de la fonction rénale</term><term>Thérapie antirétrovirale hautement active</term><term>Électrolytes (sang)</term><term>Études cas-témoins</term></keywords><keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Electrolytes</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Ghana</term></keywords><keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Infections à VIH</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Infections à VIH</term><term>Électrolytes</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections à VIH</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Antiretroviral Therapy, Highly Active</term><term>CD4 Lymphocyte Count</term><term>Case-Control Studies</term><term>Demography</term><term>Female</term><term>Humans</term><term>Kidney Function Tests</term><term>Male</term><term>Middle Aged</term><term>Statistics, Nonparametric</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Démographie</term><term>Femelle</term><term>Ghana</term><term>Humains</term><term>Jeune adulte</term><term>Mâle</term><term>Numération des lymphocytes CD4</term><term>Statistique non paramétrique</term><term>Tests de la fonction rénale</term><term>Thérapie antirétrovirale hautement active</term><term>Études cas-témoins</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Ghana</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>HAART is anticipated to result in an increase in long-term survival, but may present with the development of associated complications. The aim of this study was to assess the renal function of HIV-infected patients on antiretroviral therapy.</p></sec><sec><title>Methods</title><p>A case-control study (January to May 2013) conducted at the Suntreso Government Hospital, Kumasi, Ghana. A total of 163 HIV-infected patients (mean age 39.9±10.22) were studied, of which 111 were on HAART (HIV-HAART) and 52 were not (HIV-Controls). Serum urea, creatinine, potassium, sodium, chloride and CD4 counts were measured with the determination of eGFR (CKD-EPI and MDRD). Data was analysed using GraphPad Prism. The Chi-square, t-test, one-way ANOVA and Spearman's correlation were used. <italic>P</italic> values <0.05 were considered significant. </p></sec><sec><title>Results</title><p> Mean CD4 count of HIV-Controls was higher than that of HIV-HAART but was not significant (p = 0.304). But for sodium levels which were higher in HIV-Controls (p = 0.0284), urea (p = 0.1209), creatinine (p = 0.7155), potassium (p = 0.454) and chloride (p = 0.6282) levels did not differ significantly between both groups. All serum biochemical parameters did not differ significantly, irrespective of duration on therapy and CD4 counts. Based on regimen, sodium, chloride, urea and creatinine did not differ significantly between TDF, EVF and NVP-based therapies. Prevalence of CKD (eGFR <60 ml/min/1.73 m<sup>2</sup>) in the total population was 9.9% and 3.7% with the MDRD and EPI-CKD equations respectively. </p></sec><sec><title>Conclusions</title><p> Renal insufficiency remains prevalent in HIV patients. Changes in renal function occur in HIV infection and over the course of HAART but the difference at either stage is not significant. This suggests the role of HIV infection, HAART and the presence of traditional risk factors but not HAART in itself, in renal dysfunction. We however recommend a close monitoring of patients before and during HAART, to aid in evaluating drug combinations and implement dose modifications when necessary.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Bailes, E" uniqKey="Bailes E">E Bailes</name></author><author><name sortKey="Gaa, F" uniqKey="Gaa F">F Gaa</name></author><author><name sortKey="Chen, Y" uniqKey="Chen Y">Y Chen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Palella, Fjj" uniqKey="Palella F">FJJ Palella</name></author><author><name sortKey="Delaney, Km" uniqKey="Delaney K">KM Delaney</name></author><author><name sortKey="Moorman, Ac" uniqKey="Moorman A">AC Moorman</name></author><author><name sortKey="O, Lm" uniqKey="O L">LM O</name></author><author><name sortKey="Fuhrer, J" uniqKey="Fuhrer J">J Fuhrer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Berns, Js" uniqKey="Berns 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