Impact of Highly Active Antiretroviral Therapy (HAART) on Organs of HIV Infected Children in Abia State, Nigeria
M. O. Ajulo *
Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria.
M. K. Omole
Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria.
J. O. Moody
Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Aim: The aim of the study is to detect effect of zidovudine + lamivudine+nevirapine (AZT+3TC+NVP) on liver and kidney.
Study Design: Sixty-four children age 0 to 5 years attending FMC Umuahia were enrolled for the study in four groups.
Place of Study: Study was carried out in Antiretroviral Clinic and Pediatrics Clinic of Federal Medical Center, Umuahia in Abia State, Nigeria from February 2012 to December 2012.
Methodology: Fourteen asymptomatic immunocompromised HIV-infected children receiving HAART, AZT+3TC+NVP were in Group A. Thirty-five HIV-exposed children who initially received nevirapine for six weeks and later continued with co-trimoxazole were in Group B. Eight non-immunocompromised HIV-infected children who only received co-trimoxazole were in Group C. Group D had seven normal HIV-seronegative children who served as control for the study. A 2 ml blood was collected from the children, centrifuged to obtain serum which was analyzed in the laboratory for liver function test (AST, ALT) and kidney function test (creatinine, creatinine clearance).
Result: Thirty-three (51.6%) of the participants were male while thirty-one (48.4%) were female. ALT was highest in Group A (14.69 IU/L) followed by Group B (13.54 IU/L), Group D (7.77 IU/L) and Group C (6.12 IU/L) respectively. AST was highest in Group A (39.42 IU/L), followed by Group B (32.22 IU/L), Group C (18.66 IU/L) and Group D (14.46 IU/L) respectively. Creatinine was highest among children in Group A (57.17 µmol/l) followed by Group C (56.49 µmol/l), Group B (53.06 µmol/l) and Group D (35.42 µmol/l). Creatinine clearance was highest in Group A (100.58 ml/min/1.732m2), followed by Group D (84.48 ml/min/1.732m2), Group C (74.69 ml/min/1.732m2) and Group B (61.17 ml/min/1.732m2) respectively. The BMI was highest in Group A (32.89 kg/m2), followed by Group B (26.33 kg/m2), Group C (22.03 kg/m2) and Group D (17.34 kg/m2) respectively.
Conclusion: The study showed that HAART has significant effect on elevation of BMI and serum creatinine.
Keywords: HIV, HAART, antiretrovirals, liver, kidney, children