Prevalence of herbal medicine use and its association with renal dysfunction among patients on Tenofovir Antiretroviral Treatment based regimen at ISS Clinic Mulago

Abstract

Introduction HIV/AIDS is a major public health issue globally, with about 1.4 million infected people in Uganda by 2020. The prevalence of herbal medicine (HM) use among people living with human immunodeficiency virus (PLWHIV) is 57.6% in rural setting in western Uganda. Herbal medicine use is perceived to boost immunity and reduce the adverse events associated with antiretroviral therapy (ART). The combined use of HM and TDF-based regimen ART regimen could potentially lead to an increase in renal dysfunction cases, death and costs associated to renal dysfunction treatment and management. Hence the need to study the combined association of herbal medicine and TDF use on renal dysfunction in human population. Objective To determine the prevalence of herbal medicine use and its association with renal dysfunction among patients on tenofovir antiretroviral treatment-based regimen at ISS clinic Mulago. Methods A cross sectional study was conducted at MJAP ISS-clinic on 414 systematically selected participants living with HIV/AIDS on TDF based ART receiving routine care between March 2023 and May 2023. Data on history of herbal medicine use and ART regimen was collected using interviewer administered semi structured questionnaires and blood samples were collected for renal function analysis. Socio-demographics, potential confounding variables and drug and clinical factors data were extracted from records and all data was entered into Epidata and later to STATA version 17 for analysis. Results The prevalence of herbal medicine use was 70.8% (95% CI 66.2-74.9). The median serum creatinine levels among herbal medicine users were 96 µmol/litre and 88.8 µmol/litre among non-users. There was a significant difference in the median serum creatinine in the two groups xiii (P=0.028). There was no significant difference in the urea levels in the two groups (2.99mmol/litre in herbal medicine users versus 2.84mmol/litre in non-users, P=0.689). Herbal medicine use was significantly associated with renal dysfunction (aPR-2.31, 95% CI 1.35-3.97). Other factors that were associated with renal dysfunction were age (aPR-1.54, 95% CI 1.08- 2.22) sex (aPR-0.52, 95% CI 0.33-0.83), hypertension (aPR-3.43, 95% CI 2.47-4.76) and diabetes (aPR-1.79, 95% CI 1.39-2.31). Conclusion Health care workers should screen for herbal medicine use among patients on ART and routinely assess their renal function parameters to diagnose renal dysfunction. Ministry of Health and health care workers should put more emphasis on educating patients about the likely risks associated with herbal medicine use in combination with ART