Renal histomorphological changes following highly active antiretroviral therapy : possible role of Hypoxis hemerocallidea in an experimental animal model.

Abstract

Background: Nephrotoxicity has become an important public health problem following highly active antiretroviral therapy (HAART), and there is paucity of literature reporting the attenuating influence of plant based adjuvants that can mitigate the effects. The study investigates the role Hypoxis hemerocallidea (H. hemerocallidea) extract following HAART in an experimental animal model. Materials and Method: Sixty- three adult male Sprague-Dawley rats were used for the study and were divided into 9 groups (A-I). Group A received HAART cocktail (Lamivudine, Stavudine & Nevirapine), Group B received HAART and H. hemerocallidea extract (100 mg/kgbw), Group C received HAART and H. hemerocallidea extract (200 mg/kgbw), Group D received HAART and vitamin C, Group E received HAART and vitamin E, Group F received HAART, vitamin C and vitamin E, Group G received H. hemerocallidea extract (100 mg/kgbw), Group H received H. hemerocallidea extract (200 mg/kgbw), and Group I received water as placebo. The experiment lasted for 56 days after which, the animals were sacrificed, the kidneys were harvested and prepared for haematoxylin and eosin (H&E) histological examination and blood samples were collected through cardiac puncture and centrifuged to get the serum for blood urea nitrogen and serum creatinine analyses. Results: Kidney weight changes were not significant except for group A that recorded a significant increase (p<0.05) and group B that recorded lowest body weight when compared with the control. Organbody weight ratios were significantly higher in group A and group F (p<0.05). Adjuvant treatment with H. hemerocallidea (in groups B and C) with HAART resulted in increased organ-body ratio, but however not significant. Serum Creatinine (SCR) and blood urea nitrogen (BUN) levels were statistically elevated in HAART-treated animals (p<0.05, 0.001). SCR levels in group D was significantly reduced (p<0.05) but however, significantly elevated in groups B, C, G and H (p<0.001). Groups B and C, as well as groups F and H resulted in higher BUN values (p<0.05). The histological appearance of group A was highly compromised. When treated concomitantly with H. hemerocallidea (at both dosages), no attenuating influence was seen. However, low dose of H. hemerocallidea showed improved histological layout as compared to the high dose. Co-administration of HAART and combined dose of vitamin C and E did not improve the histoarchitecture. Conclusion Adjuvant treatment with H. hemerocallidea extract did not attenuate the nephrotoxicity of HAART in this model.