Correlates of Impaired Renal Function in Highly Active Antiretroviral Therapy (HAART) Naive HIV Infected Patients in Maiduguri, Nigeria

Abstract

Background : Although renal function may be abnormal in as many as 30% of HIV -1 patients even in the era of highly active antiretroviral therapy, it may not be apparent at the initial stage and laboratory tests are needed to detect it. We determined the factors associated with impaired renal function in HIV infected patient initiating highly active antiretroviral therapy in North-eastern Nigeria. Materials and Methods : This was a retrospective study among HIV-1 infected patients that presented at infectious diseases clinic at the university of Maiduguri Teaching Hospital(UMTH) for care between July 2008- March 2009. Data were analysed for age, gender, weight, height, WHO clinical stage, HIV-1 RNA viral load, HBsAg and anti-HCV antibody status. Estimated glomerular filtration rate eGFR was calculated using the Cockcroft #x2013;Gault equation. Results : A total of 415 participants with mean age of 43.65#xB1;9.70 (95% CI; 42.77 #x2013; 44.52), were considered for this study. Out of this 182 (43.6%) were males, with a mean age of 47.43#xB1;9.00, they were older than females with mean age of 40.54#xB1;9.08 (plt;0.05). A total of 61(14.7%) had an eGFRlt;60mL/min, with disproportionately more males (17.0%vs 12.5%) having eGFRlt;60mL/min than females (plt;0.05). On multivariate analysis, older age ( #x2265;50 years), anaemia (Hblt;10g/dl), abnormal BMI (lt;18.5 kg/m2 or gt;25.0 kg/m2) had significant associations with reduced GFR. Conclusion : Older age, anaemia and abnormal weight are independently associated with risk of having impaired renal function in our cohort. We therefore recommend renal function tests to HIV infected patients at commencement of highly active antiretroviral therapy for effective and proper management.