title: Assessment of the effect of antiretroviral therapy on renal and liver functions among HIV-infected patients: a retrospective study.
abstract: BACKGROUND
  The emergence of highly active antiretroviral therapy (HAART) has dramatically improved quality of life in prolonging survival of human immunodeficiency virus (HIV)-infected patients on treatment in developed as well as developing countries. However, the main shortcoming of HAART in long-term use is its potential to cause liver and kidney derangements that may be life threatening. The drugs are actively accumulated in the proximal renal tubule resulting in functional disturbance with mitochondrial injury being one of the most important targets recognized. Therefore, the aim of this study was to assess the adverse effects of HAART on kidney and liver functions among HIV-infected patients presenting to the University of Gondar Hospital, Ethiopia.
  
  
  METHODS
  An institution-based retrospective study was conducted from 2010 to 2015 on a subset of HIV-infected patients. Data were collected from the registration book of the University of Gondar Hospital antiretroviral clinic laboratory after checking the completeness of age, gender, creatinine, blood urea nitrogen, and alanine aminotransferase level. Data were entered and analyzed using SPSS version 20. Descriptive statistics, chi-square test, one-way analysis of variance, and logistic regression were done to determine associations. AP-value <0.05 was considered statistically significant.
  
  
  RESULTS
  A total of 275 study subjects were included in the study. Of these, 62.2% were females, and the overall prevalence of chronic kidney disease (CKD) before and after treatment was 3.6% and 11.7%, respectively. A majority of the CKD patients were in stage 3 for patients after treatment. The overall prevalence of hepatotoxicity was 6.5% and 16.7% before and after treatment, respectively. A majority of the patients developed Grade 2 hepatotoxicity 66.7% and 65.2% before and after treatment, respectively. Binary and multiple logistic regression analysis indicated that the female gender was a risk factor for CKD.
  
  
  CONCLUSIONS
  The prevalence of nephrotoxicity and hepatotoxicity were high among patients who took HAART. Stage 3 nephrotoxicity and Grade 2 hepatotoxicity had the highest incidences of the total toxicities, and the female gender was a risk factor for nephrotoxicity. Further prospective studies are recommended to determine the effect of HAART and contributing factors.
authors.affiliation: Department of Clinical Chemistry.
authors.forename: Habtamu
authors.initials: H
authors.lastname: Wondifraw Baynes
authors.affiliation: Department of Medical Microbiology.
authors.forename: Birhanemeskel
authors.initials: B
authors.lastname: Tegene
authors.affiliation: Department of Medical Laboratory Science, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Mikiyas
authors.initials: M
authors.lastname: Gebremichael
authors.affiliation: Department of Medical Laboratory Science, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Gebrehawaria
authors.initials: G
authors.lastname: Birhane
authors.affiliation: Department of Medical Laboratory Science, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Wabe
authors.initials: W
authors.lastname: Kedir
authors.affiliation: Department of Clinical Chemistry.
authors.forename: Belete
authors.initials: B
authors.lastname: Biadgo
keywords: CKD; Ethiopa; Gondar; HAART; hepatotoxicity; nephrotoxicity