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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

HAART, DOTS and renal disease of patients co-infected with HIV/AIDS and TB in the South West Region of Cameroon

Zeitschrift:
BMC Public Health > Ausgabe 1/2015
Autoren:
Dickson Shey Nsagha, Benjamin Thumamo Pokam, Jules Clement Nguedia Assob, Anna Longdoh Njunda, Odette Dzemo Kibu, Elvis Asangbeng Tanue, Charlotte Wenze Ayima, Patrick Elroy Weledji
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contribution

NDS participated in the conception, design, data collection, data analysis, drafting and revising the manuscript for academic content. PTB participated in the design, data management, analysis, interpretation and revised the manuscript. KOD conceived the study, participated in data analysis and interpretation and drafted the manuscript. NAL participated in the design, literature search, analysis and interpretation of results. ANJC contributed in the literature search and correction of the final manuscript. TEA participated in the design, data collection, performed the data analysis, literature search, drafting and correction of the final manuscript. ACW participated in the literature search, data analysis, drafting, reading and correcting the final manuscript. WEP participated in the literature search, analysis and interpretation of results, drafting, reading and correcting the final manuscript. All authors read and approved the final copy.

Authors’ information

Not applicable.

Abstract

Background

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.

Methods

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.

Results

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 m2 (10/70 (14.3 %) vs. 1/70 (1.4 %), OR = 11.5 [1.4–92.5], p = 0.02) 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).

Conclusion

Compared to adults on DOTS, adults on HAART were more likely to have renal dysfunction (eGFR <60 ml/min per 1.73 m2). 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.
Literatur
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