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Factors Associated with Antiretroviral Therapy Toxicity Out-Comes in Patients with and without Hypertension

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  • Sabelo Bonginkosi Dlamini

    (Department of Public Health, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
    PhD Program in Environmental and Occupational Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
    Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan)

  • Ming-Tsang Wu

    (Department of Public Health, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
    PhD Program in Environmental and Occupational Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
    Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
    Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan)

  • Hans-Uwe Dahms

    (Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
    Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
    Department of Marine Biotechnology and Resources, National Sun Yat-sen University, Kaohsiung 80708, Taiwan)

Abstract

Background: Negative effects of antiretroviral therapy (ART) drugs on HIV/AIDS patients are one of the major health issues in the therapeutic treatment of this communicable disease. This holds particularly for people living with HIV (PLHIV) who might have a non-communicable disease (like hypertension), which also requires a lifetime treatment. In this study, we investigated the association between hypertension and other possible factors on ART toxicity markers in patients with hypertension, compared to those without hypertension. Methods: This retrospective longitudinal study reviewed chronic patient files of 525 patients (of which 222 were hypertensive) who satisfied the inclusion criteria and were on ART at a hospital in central Eswatini. Specific levels of estimated glomerular filtration (eGFR), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were used as drug toxicity markers. To analyze the longitudinal data between the exposure of interest and outcome variables, a Generalized Estimated Equation method was employed. Results: Participants with hypertension had decreased eGFR compared to those without hypertension (β = −2.22; p -value = 0.03). There was no significant association between ALT, AST and hypertension ( p -value = 0.34 and 0.20, respectively). Factors that were found to have a significant association with ART toxicity markers included age, sex, ART duration, hypertension treatment and time of study. The eGFR was found to be significantly increasing over the study period ( p -value < 0.001) for all participants. The significance was consistent in both hypertensive and non-hypertensive participants independently ( p -value = 0.002 and <0.001, respectively). The overall trends of ALT and AST over time were also significant ( p -value = 0.003 and <0.001, respectively). Conclusions: Patients with hypertension had decreased eGFR, and there was a significant association of eGFR with time of the study. Special attention, therefore, to monitor calamities which are indicated by a decrease of eGFR (like renal impairment) should be given in PLHIV on ART with hypertension, especially more so if they were on ART for longer time.

Suggested Citation

  • Sabelo Bonginkosi Dlamini & Ming-Tsang Wu & Hans-Uwe Dahms, 2022. "Factors Associated with Antiretroviral Therapy Toxicity Out-Comes in Patients with and without Hypertension," IJERPH, MDPI, vol. 19(17), pages 1-18, September.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:17:p:11051-:d:906092
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    References listed on IDEAS

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    1. Helen Bygrave & Katharina Kranzer & Katherine Hilderbrand & Guillaume Jouquet & Eric Goemaere & Nathalie Vlahakis & Laura Triviño & Lipontso Makakole & Nathan Ford, 2011. "Renal Safety of a Tenofovir-Containing First Line Regimen: Experience from an Antiretroviral Cohort in Rural Lesotho," PLOS ONE, Public Library of Science, vol. 6(3), pages 1-5, March.
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