Reasons for Antiretroviral Drug Switch Among Patients Attending at the Antiretroviral Therapy Clinic of Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia

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Addis Ababa University


Background: The Human Immunodeficiency Virus (HIV) destroys and impairs the function of immune cells which results in increased susceptibility to a wide range of diseases. HIV continues to be a major global public health issue, having claimed more than 34 million lives so far. Globally there were approximately 37 million people living with HIV and about 15 million (40%) were receiving antiretroviral treatment (ART) at the end of 2014. ART has revolutionized the treatment of HIV and transformed this infection from a fatal to a medically managed disease. Objective: This study was performed to determine the reasons for anti-retroviral drug changes among patients on follow up at ART clinic, Tikur Anbesa Specialized Hospital. Methods: The study was a hospital based retrospective cross-sectional study conducted from 10 June to 10 September 2015, using a pre-tested data collecting form and chart review. Among patients who experienced antiretroviral drug switch, 259 were included in the study using systematic random sampling. Results: The main reasons for initial antiretroviral switches was toxicity (74.1%), undocumented reason (7.3%), adherence difficulty (6.5%), treatment failure (4.2%) and pregnancy (2.3%). The major toxicity types were lipodystrophy (33%) anemia (16.7%), and peripheral neuropathy (15.8%) with Stavudine based regimen being the major (78.5%) toxicity causing anti-retroviral regimen. Among the 259 patients 54 (20.8%) of them switched for the second time 3 (1.2%) for the third time. The main reason for the second switch was toxicity (31.5%), adherence difficulty (20.4%), treatment failure (20.4%) and pregnancy (11.1%). Conclusion: The reason for initial ARV drug switch was significantly associated to the type of initial ART regimen. The occurrence of second ARV drug switches was associated to the type of ART regimen, clinical stage and duration of stay on firstly switched ART. With few exceptions, almost the entire ART initiation and change pattern was in line with the national and WHO guidelines on the use of antiretroviral drugs. Key words: HIV, ARV drug switch, Tikur Anbesa Specialized Hospital, Reason for change



HIV; ARV drug switch; Tikur Anbesa Specialized Hospital; Reason for change