Eyob Gebretsadik
Ethiopian Ministry of Health, Ethiopia
Title: Evidence basred care on monitoring of toxicity of TDF among HIV positive Pregnant and Lactating mother who are on haart in Ethiopia
Biography
Biography: Eyob Gebretsadik
Abstract
Increasing incidence of Fanconi, proximal kidney tubular damage and declining GFR are becoming more common in HIV positive pregnant women. Recently stronger evidence from the practice has drawn clinicians’ attention to monitor the toxicity of TDF before initiation and during follow up. The objective of the study to generate evidence based laboratory monitoring of GFR using simple android based calculation of GFR to early identify and manage Chronic renal disease (CRD) among TDF based HAART users of pregnant and lactating women.. HIV+ pregnant and lactating women on TDF based HAART(n=111) enrolled from three general hospitals to be closely followed for incidence of CKD based on NKF K/DOQI .24.3% of subjects had a gfr of 90-131 ml/min, 16.2 % mild decline of GFR 60-89 ml/min while 3.6% (n=4) had stage-5 (< 15ml/min/m2) kidney failure that required dialysis. HIV+ lactating women had stronger association with RR of 0.918 and 95% CI of 0.845-0.998. Stage 5 CKD had been observed among WHO clinical stage-1 (P=0.014) with odds ratio of 5.4 and 95% CI (1.24-24.42), baseline CD4 > 500 with cohort risk estimate of 4.103 with 95 % CI (1.02, 16.54) (P=0.02). The prevalence of stage-2 kidney diseases is significantly associated lower BMI of below18.5, clinical stage-1, and CD4 > 500. Thus a close laboratory monitoring schedule for pregnant women and GFR calculation using simple android application, and early diagnosis of toxicity and management as to the WHO guide is mandatory.