Nephroprotective Effect of Highly Active Antiretroviral Therapy among HIV Seropositive Individuals: A Case-Control Study in Ghana

Abstract

Background: Despite the widespread use of highly active antiretroviral therapy (HAART), renal insufficiency still exists among HIV infected individuals. This study aimed to use creatinine-based equations to determine the role of highly active antiretroviral therapy on renal function. Methods: One hundred and ninety-two (192) HIV individuals consisting of one hundred and four (104) HIV patients on HAART and eighty-eight (88) HIV HAART naïve patients were recruited into the study. Serum creatinine, urea, CD4 count and weight were determined. Glomerular filtration rates were estimated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Kidney Disease (MDRD) equations. Result: The calculated renal insufficiency (eGFR<60 ml/min /1.73 m2) among the studied population was (7.8% for CKD-EPI and 10.9% for MDRD).The prevalence of renal insufficiency in HAART individuals was lower (1.9% for CKD-EPI and 2.9% for MDRD) than HAART naïve individuals (14.7% for CKD-EPI and 20.4% for MDRD). Conclusion: The results of this study provide evidence of a significant improvement in renal function and a reduced prevalence of renal insufficiency among HIV individuals on HAART showing the importance and the effectiveness of HAART in improving renal function. Our result confirms the safety of tenofovir regimens given the fact that none of the patients on tenofovir-based regimen had renal insufficiency.