Relationship Between Common Markers of Inflammation and Renal Disease Among Apparently Healthy HIV Patients in Benin City, Nigeria

Abstract

Renal impairment is one of the frequent complications of HIV infection. The relationships between some common markers of inflammation and chronic kidney disease (CKD) have recently been investigated but not in HIV patients. Therefore, this study determined the relationship between these markers of inflammation and renal disease among apparently healthy HIV patients in Benin City, Nigeria. The study was a cross sectional study. Blood samples were collected and used to estimate the levels of some inflammatory markers (such as Albumin, CD4 count, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and systemic immune-inflammatory index (SII) and some biochemical parameters such as electrolytes, urea, creatinine and estimated glomerular filtration rate (eGFR) among 173 participants comprising 81 HIV patients on Highly Active Antiretroviral Therapy (HAART), 44 HAART-naïve HIV patients attending out-patients clinics in the University of Benin Teaching Hospital, Benin City and 48 non-HIV individuals (Controls). Healthy control subjects had significantly (p<0.05) higher haematocrit and haemoglobin concentration than their HIV-positive counterparts. The MCH, MCV, and MCHC values of HIV patients on HAART were significantly higher than those of their HAART-naive counterparts and healthy control subjects (p<0.05). HAART-naïve HIV patients had significantly higher NLR, PLR and SII (P<0.05) and significantly lower CD4 count and albumin (P<0.0001) than other study groups. The eGFR of HIV patients on HAART were markedly higher than those of HAART-naïve HIV patients (p<0.05) and healthy controls (p<0.01). The prevalence of CKD was 9.09%, 8.64% and 0% among HAART-naïve HIV patients and HIV patients on HAART and non-HIV subjects, respectively. A significant negative correlation was observed between some inflammatory markers (NLR, PLR and SII) and eGFR among HAART-naïve HIV patients. This study underscores inflammation as a possible cause of renal failure among asymptomatic HAART-naïve HIV patients.