Haematological and biochemical response to treatment of HIV-1 infection with a combination of nevirapine + stavudine + lamivudine in Lagos Nigeria

To evaluate the effect of a combination of nevirapine + stavudine + lamivudine on Haematological and Biochemical values of HIV-1 positive patients in Lagos. Fifty patients who met the enrollment criteria for accelerated clinical trial were studied. Ten millimeters of blood was taken from each patient at first visit for basic haematological and biochemical values. Viral load and CD4 cell counts were also analyzed. All the values were repeated at 12 weeks, and 24 weeks, after patients were placed on drug treatment regimen. All the data were analyzed using Epi-info version 6.4D. The mean erythrocyte sedimentation rate (ESR) results were 53.3 ± 41.8 mm/1 hr, 48.2 ± 40.6 mm/1 hr and 28.6 ± 20.7 mm/1 hr. Haemoglobin (Hb) 123 ± 15 g/L, 124 ± 21 g/L and 132 ± 14 g/L. Packed cell volume 36.8 ± 4.5%, 37.6 ± 4.8%, and 40.3 ± 3.3%. Total white blood cell (WBC) 4.2 ± 1.0, 5.0 ± 1.5 and 4.6 ± 1.0 (baseline, 12 weeks and 24 weeks respectively). Creatinine, 1.2 ± 0.68 g/L, 1.2 ± 0.7 g/L and 1.04 ± 0.3 g/L at (baseline, 12 weeks and 24 weeks respectively). Serum amylase 37.9 ± 15.1 IU/L, 38 ± 23.9 IU/L and 24.3 ± 11.6 IU/L. Triglyceride 95.2 ± 48.3 IU/L, 92.38 ± 54.3 IU/L, and 78.0 ± 35.6 IU/L. Serum bilirubin 0.18 ± 0.09 μmol/L, 0.29 ± 0.28 μmol/L and 0.33 ± 0.24 μmol/L. Alanine transaminase (ALT) 9.9 ± 3.3 IU/L, 15.1 ± 9.0 IU/L and 14.1 ± 9.3 IU/L. Serum aspartate transaminase (AST) 8.2 ± 6.2 IU/L, 9.4 ± 5.2 IU/L and 9.1 ± 6.0 IU/L. On comparison of the results between baseline and 12th week, all parameter were similar except PCV, Hb, serum bilirubin, serum ALT, and total WBC, which were significantly high at 12th week. (p≤ 0.05). On comparison of results between 12th week and 24th week all parameters were similar except Hb and PCV (which were significantly higher at 24th week) while ESR, was significantly lower at 24th week (p≤ 0.05). It was concluded that nevirapine + stavudine + lamivudine combination results in improved haematological values of HIV/AIDS patients. The effect of the drug combination on biochemical parameter in a short period of 24 weeks may not be much. Clinical response and haematological response alone may be used for patient monitoring in a resource poor setting where CD4 count and viral load analysis is impossible.