Renal Function and Nephrotoxicity Assessment in People Living with HIV on Tenofovir, Lamivudine, and Dolutegravir Therapy: A Cross-Sectional Study in Nigeria

Abstract

Abstract Introduction: Antiretroviral therapy (ART) has revolutionized HIV treatment, but concerns regarding renal toxicity persist. Evaluating the renal effects of the tenofovir, lamivudine, and dolutegravir (TLD) regimen in people living with HIV (PLWH) is crucial. This study investigates potential renal toxicity associated with TLD therapy among PLWH at a Nigerian military hospital. Materials and Methods: We employed a comparative cross-sectional design, sampling 170 subjects. One hundred and twenty HIV-seropositive clients on TLD were matched with 50 HIV-seronegative controls based on age, sex, and ethnicity. Data collection involved a structured questionnaire and blood sampling. Plasma was analyzed for electrolytes, urea, creatinine, uromodulin (UMOD), and nephrin levels. Continuous variables were analyzed using appropriate statistical tests, including Student’s t -tests and ANOVA. Statistical analysis was performed using SPSS, with a significance level set at P < 0.05. Results: Significant differences were observed between the two groups in levels of potassium, chloride, urea, creatinine, UMOD, and nephrin. HIV-positive participants exhibited higher potassium and creatinine levels, while chloride levels were slightly lower. Elevated urea and creatinine levels in HIV-positive individuals indicate possible waste accumulation. Lower UMOD levels suggest compromised kidney health. Conclusion: This study highlights potential kidney dysfunction and nephrotoxicity in HIV-positive individuals on TLD therapy, evidenced by altered electrolyte levels and increased urea and creatinine. The inclusion of ART-naïve individuals in future studies could help isolate the effects of TLD from the underlying HIV infection. We recommend further research to explore the underlying mechanisms and long-term implications of these findings in PLWH on TLD therapy.