Changes In Immunological, Biochemical And Hematological Parameters Of Hiv-1 Positive Patients On Antiretroviral Therapy In Mbagathi County Hospital, Nairobi

ABSTRACT

Human immunodeficiency virus or acquired immunodeficiency syndrome remains the leading cause of death in sub-Saharan Africa, Kenya being one of them. Over 407,000 patients were on antiretroviral therapy by the year 2015 nationally. Despite sustained clinical benefits associated to usage of antiretroviral drugs, adverse effects are emerging as a major safety concern. Some of the factors that have been identified as having an influence on the effect of ARV in disease control include age, gender, time of initiation of therapy, and drug combination. Currently, there are limited data highlighting the toxicities associated with ARV use in Kenya. This study was therefore designed to determine effects of antiretroviral therapy on the hematological, biochemical, virological and immunological parameters among HIV patients followed for 12months on initiation of antiretroviral therapy. A total of 138 HIV1positiveindividualsmeet the recruitment criteria, however, 5 individuals dropped out of the study for other reasons. Blood samples were collected before treatment initiation, in the sixth and twelfth month after initiation of antiretroviral therapy. Two treatment regimes were employed stavudine lamuvudine and niverapine (n=28), and zidovudine, lamuvudine and niverapine (n=105).The mean of the two treatment combinations had no significant difference in all the assay factors except for transaminase and were discussed as same. Laboratory measurements included levels of aspartate transaminase, alanine transaminase, complete blood cell counts, CD4 cell counts and plasma HIV-1 viral load and changes in body weight. There were three age groups(18-35 years)youthful and,(36-45 years) adult economically active and above 46 years physiologically less active. The 133 individuals recruited included 88 females and 45males. Body weight increased from mean of 58.29kg at baseline to 61.14kg at month 6 (Z = -7.537, ρ< 0.05) and to 62.11kg at month 12 (Z = -7.694,ρ< 0.05). Stavudine combination was associated with low level hepatotoxicity of 3%at month 6 (ρ