Impact of ART Adherence on Liver and Kidney Function in HIV-infected Individuals in Nigeria

Abstract

Background: Poor adherence to antiretroviral therapy (ART) may worsen organ impairment in persons living with HIV (PLHIV). Objective: To assess the effect of ART adherence on hepatic and renal functions in patients with HIV. Methods: A cross-sectional comparative study was conducted among 90 participants (30 ART-adherent HIV-positive participants, 30 ART-non-adherent HIV-positive participants, and 30 HIV-negative controls). Serum biochemical parameters (liver enzymes: AST, ALT, and ALP; bilirubin; kidney function: urea, creatinine, and electrolytes) were determined using standard colorimetric methods. Data were analysed using one-way ANOVA followed by post-hoc LSD and Student’s t-tests in SPSS version 25 (p < 0.05). Results: ART-non-adherent participants had significantly higher liver enzymes (AST, ALT, and ALP), total and conjugated bilirubin, urea, creatinine, sodium and potassium levels compared with adherent participants and controls (p < 0.05). The profiles of adherent participants were akin to those of HIV-negative controls. Among non-adherent patients, sodium levels differed significantly among regimens (p < 0.05), and longer interruption (7–12 months) was associated with worse biochemical derangements than shorter interruption (3–6 months) (p < 0.05). Conclusion: Non-adherence to ART is strongly associated with hepatic and renal dysfunction. Long-term adherence preserves organ function. Routine monitoring, adherence counselling and re-engagement strategies are recommended.