Assessment of the Prevalence of Adverse drug Reaction among HIV-infected Adults on anti Retroviral therapy and Factors Associated with it at Zewditu Memorial Hospital
No Thumbnail Available
Date
2007-02
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Abeba Universty
Abstract
Background: The success of Anti Retroviral Treatment (ART) is highly dependent on
adherence to complex ARV regimens. Unfortunately, up to 25% of patients discontinue
their initial HAART regimen mainly because of toxic effects.
Objectives: To assess the magnitude of adverse drug reactions (ADRs) and associated
factors among patients on Anti Retroviral Treatment
Methods: Out of the source population that consisted of 3240 adult AIDS patients
started on ART at Zewditu Memorial Hospital from January 2004 to December 2005, 554
study subjects’ clinical records were selected using systematic random sampling
technique. The study was an institution based cross sectional study conducted using
review of clinical records of adult patients on ART to examine the status of ADRs and
factors associated with it among patients on ART. Independent predictors of the
development of ADRs, types and severity were assessed with binary logistic regression.
Results: Out of the total of 554 clinical records, 526 (94.9%) were reviewed. At least one
of the drugs was changed in 120(22.8%) of the patients. There were 73 (13.7%) lost for
follow up. The main reasons for changing ARV drugs were toxicity/side effects 97(81%)
followed by illness in 14(12 %), and pregnancy in 4(3%). The frequency of ADRs was
124(24%). The most frequently diagnosed ADRs were Anemia 42(33.9%) followed by
Peripheral Neuropathy 35 (28.2%) and Elevated ALT 31(25%). Majority 94(75.8%) of the
ADRs were classified as grade III. Variables associated with ADRs were regimen
containing NEV (OR=1.60; CI=1.04-2.47), treatment durations 6-10, 11-15 and >15
months OR 3.50 (1.47, 8.33), 3.36 (1.34, 8.40) and 5.08 (2.20, 11.75) respectively and
taking other drugs (OR=1.80; CI=1.06- 3.03).
Conclusions: Relatively very high rate of changing of drugs was noted with in first line
regimen drugs, with high lost to follow up rate which may shorten the durability of the first
line regimen. The most frequent ADR was anemia followed by Peripheral Neuropathy
and Elevated ALT. The type of ADRs that the patient developed was very much
associated with the duration of treatment and the regimen. Therefore, early diagnosis
and appropriate management of ADRs is reckoned to decrease the rate of changing first
line drugs which eventually maintain their efficacy and durability.
Description
Keywords
Assessment of the Prevalence of Adverse drug Reaction