Human Immunodeficiency Virus: Assessment of the hepatotoxic, nephrotoxic, and pancreatic toxic effects of antiretroviral therapy in people living with HIV in Brazzaville

Antiretroviral therapy (ART) has markedly improved the survival of people living with Human Immunodeficiency Virus (HIV) People Living with HIV (PLHIV), but prolonged treatment may cause hepatic, renal, and pancreatic toxicities.Data on these complications remain limited in the Republic of Congo.Methods: A longitudinal before-and-after study was conducted from June to December 2025 among 132 adults receiving ART for at least six months.Serum creatinine estimated creatinine clearance, aspartate aminotransferase (AST), Alanine Aminotransferase (ALT), serum amylase, and fasting blood glucose were assessed at baseline Month 0 (M0) and after at least six months of treatment (M≥6).Paired comparisons were performed, with statistical significance set at p < 0.05.Results: The mean age was 52.3 ± 11.9 years, and 72.7 of participants were women.The most frequently prescribed regimen was dolutegravir/lamivudine/tenofovir disoproxil fumarate (75%).Significant changes were observed in serum creatinine (p = 0.040), creatinine clearance (p = 0.007), serum amylase (p = 0.027), and ALT (p = 0.003).No significant changes were found for AST or fasting blood glucose.Conclusion: ART was associated with significant renal, hepatic, and pancreatic biochemical alterations, highlighting the need for routine biological monitoring to facilitate early detection and management of treatmentrelated toxicities.