Hepatotoxicity and Anaemia Co-morbidity in Treated HIV Patients in Fundong Subdivision in the Northwest Region of Cameroon

Aims: Hepatotoxicity and anaemia are relevant adverse effects of highly active antiretroviral therapy (HAART) and can cause interruption of therapy and death. However, there is dearth of information on hepatotoxicity and anaemia co-morbidity especially in rural areas. The aim of the study was to identify the prevalence of Hepatotoxicity and Anaemia co-morbidity among HIV patients treated with either Zidovudine + Lamivudine + Efavirenz or Zidovudine + Lamivudine + Nevirapine or Tenofovir + lamivudine + Efavirenz in Fundong.

Study Design: In total, 150 drug naïve patients who have been followed up for 18 months with age between 15 and 74 years were recruited into the study. Baseline and 18 months levels of CD4 counts, alanine transaminase (ALT), and aspartate transaminase (AST) and Haemoglobin concentration (Hb) were determined.

Place and Duration of Study: Samples were collected from patients visiting the day hospital in Fundong District Hospital between January-March 2015.

Methodology: HIV was diagnosed using Alere determine HIV rapid test kit and Bioline or Oral Quick test kit for the confirmatory test. CD4 counts were determined using the Alere Pima™ CD4 cartridge machine. Hb, ALT and AST counts were determined by colometric enzymatic reaction using the urit 3300 machine and classified based on age and sex.

Results: The majority of patients were female 115(76.7%) and belonged to the <30 years age range 48(32%). The prevalence of anaemia decreased from 86(57.3%) to 69(45.6%) at the end of the study period. In all, 46(30.7%) patients had hepatotoxicity and anaemia co-morbidity which was higher in the age group <30 years 30(41.7%) and in female 37(32.2%). A total of 1(0.7%) and 10(6.7%) patients developed severe hepatotoxicity using ALT and AST respectively. The prevalence of hepatotoxicity was higher in male (31.4% and 62.9%) and in the age group 30-39years (29.5% and 68.2%) for ALT and AST, respectively. The prevalence of anaemia and elevated AST and ALT were higher in persons with CD4 <200cells/μl. There was a significant correlation (P<0.001) between CD4 and Hb (r=0.193), CD4 and ALT(r=-0.149) and CD4 and AST(r=-0.193).

Conclusion: Hepatotoxicity especially Grades 1-2 and not anaemia is a significant adverse effect of HAART upon time.