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. 2018;16(6):436-446.
doi: 10.2174/1389450120666190214144609.

Antiretroviral Therapy-associated Adverse Drug Reactions and their Effects on Virologic Failure- A Retrospective Cohort Study in Nigeria

Isaac O Abah  1   2 , Nondumiso B Q Ncube  1 , Hazel A Bradley  1 , Oche O AgbaJi  3 , Phyllis Kanki  4
Affiliations

Antiretroviral Therapy-associated Adverse Drug Reactions and their Effects on Virologic Failure- A Retrospective Cohort Study in Nigeria

Isaac O Abah et al. Curr HIV Res. 2018.

Abstract

Background: Adverse drug reactions (ADRs) associated with antiretroviral therapy (ART) can rapidly reverse the gains of ART resulting in poor health outcomes. We need an improved understanding of specific ART-related ADRs that influence virologic outcomes.

Objective: To investigate the frequency of clinical ADRs and assess their effect on virologic failure in patients on ART.

Method: We described the prevalence of major clinical ADRs, and the association between specific ADRs and virologic failure in a clinic cohort of HIV-1 infected Nigerians aged ≥18 years, on firstline ART between June 2004 and February 2012. Multivariable logistic regression was run to identify predictors of virologic failure at 24 and 72 weeks of ART.

Results: Data of 12,115 patients with a median age of 34 (interquartile range: 29-41) years, and predominantly females (67%) were evaluated. Overall, 957 (7.9%) patients experienced at least one ADR during a median follow-up period of 4 years (interquartile range: 1-7). The three most prevalent ADRs were lipodystrophy (2.6%), anemia (1.9%), and skin rash (0.7%). Virologic failure rate was 36% and 34% at 24 and 72 weeks of ART, respectively. Anemia independently predicted the odds of virologic failure at 72 weeks of ART (adjusted odds ratio, 1.74; 95% CI: 1.2-2.51); adjusted for sex, age, pre-treatment CD4+ cell count, antiretroviral regimen, and medication refill adherence.

Conclusion: Antiretroviral therapy-associated anemia increases the likelihood of late virologic failure. We recommend routine monitoring of hemoglobin levels and prompt management of anemia in all patients on ART as a strategy to improve virologic success rates.

Keywords: Adverse drug reaction; anemia; antiretroviral therapy; toxicity; treatment failure; viral suppression..

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References

    1. Montaner J.S.G., Reiss P., Cooper D., et al. A Randomized, double-blind trial comparing combinations of nevirapine, didanosine, and zidovudine for HIV-infected patients. JAMA. 1998;279:930–937. - PubMed
    1. Dieffenbach C.W., Fauci A.S. Thirty years of HIV and AIDS: future challenges and opportunities. Ann. Intern. Med. 2011;154:766–771. - PubMed
    1. Cambiano V., Lampe F.C., Rodger A.J., et al. Long-term trends in adherence to antiretroviral therapy from start of HAART. AIDS. 2010;24:1153–1162. - PubMed
    1. Tanser F., Bärnighausen T., Grapsa E., Zaidi J., Newell M-L. High coverage of ART associated with decline in risk of HIV acquisition in rural KwaZulu-Natal, South Africa. Science. 2013;339:966–971. - PMC - PubMed
    1. Deeks S., Lewin S., Havlir D. The end of AIDS: HIV infection as a chronic disease. Lancet. 2013;382:1525–1533. - PMC - PubMed

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