title: HAART, DOTS and renal disease of patients co-infected with HIV/AIDS and TB in the South West Region of Cameroon.
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 m(2) (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).
  
  
  CONCLUSIONS
  Compared to adults on DOTS, adults on HAART were more likely to have renal dysfunction (eGFR <60 ml/min per 1.73 m(2)). 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.
authors.affiliation: Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, P.O Box 12, Buea, Cameroon. nsaghads@hotmail.com.
authors.forename: Dickson Shey
authors.initials: DS
authors.lastname: Nsagha
authors.affiliation: Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, P.O Box 12, Buea, Cameroon. thumamo@yahoo.fr.
authors.forename: Benjamin Thumamo
authors.initials: BT
authors.lastname: Pokam
authors.affiliation: Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, P.O Box 12, Buea, Cameroon. juleclement@yahoo.fr.
authors.forename: Jules Clement Nguedia
authors.initials: JC
authors.lastname: Assob
authors.affiliation: Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, P.O Box 12, Buea, Cameroon. ann_njunda@yahoo.com.
authors.forename: Anna Longdoh
authors.initials: AL
authors.lastname: Njunda
authors.affiliation: Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, P.O Box 12, Buea, Cameroon. yayaodette@yahoo.com.
authors.forename: Odette Dzemo
authors.initials: OD
authors.lastname: Kibu
authors.affiliation: Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, P.O Box 12, Buea, Cameroon. asangbengelvis@gmail.com.
authors.forename: Elvis Asangbeng
authors.initials: EA
authors.lastname: Tanue
authors.affiliation: Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, P.O Box 12, Buea, Cameroon. ayimacharlotte@yahoo.com.
authors.forename: Charlotte Wenze
authors.initials: CW
authors.lastname: Ayima
authors.affiliation: Department of Surgery, Obstetrics and Gynaecology, Faculty of Health Sciences, University of Buea, P.O Box 12, Buea, Cameroon. elroypat@yahoo.co.uk.
authors.forename: Patrick Elroy
authors.initials: PE
authors.lastname: Weledji
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data*; D002163:Cameroon / Q000453:epidemiology; D060085:Coinfection / Q000196:embryology* / Q000453:epidemiology*; D003141:Communicable Diseases / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D007674:Kidney Diseases / Q000188:drug therapy / Q000453:epidemiology*; D007677:Kidney Function Tests; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019829:Nevirapine / Q000627:therapeutic use; D015995:Prevalence; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D019829:Nevirapine