STUDY OF ADVERSE EFFECTS OF ANTI RETROVIRAL THERAPY IN HIV NAÃVE PATIENTS AND THEIR ASSOCIATION WITH CD4 CELL COUNT
Abstract
Background: Acquired immunodeficiency syndrome (AIDS) is a disease of the human immune system and leaves the body vulnerable to a variety of life-threatening infections and cancers. AIDS is characterized by changes in the population of CD4 T-cell lymphocytes that play a key role in the immune defense system. However adverse drug reactions (ADR) related to HAART has limited its utility and compliance.
Aim: To study the adverse effects of ART and its correlation with CD4 cell count in a resource-restricted setting in central India.
Methods: 152 HIV naive patients on ART were studied prospectively over a period of 18 months. All patients were asked to visit the clinic if they developed any symptoms or on a six monthly basis along with CD4 count done at every six month. They were screened clinically and investigated suitably for any ADRs.
Result: Out of the 152 patients, nine patients lost for follow-up and fourteen died; 129 cases were available for evaluation. ADRs were observed in 98 cases (75.4percent). Only hepatic 29percent and cutaneous (24percent), adverse effects were seen in patients with higher CD4 Cell count whereas other adverse effects like hematological (38percent), gastrointestinal (30percent), neurological (24percent) and metabolic (10) were more common with lower CD4 cell count.
Conclusion: To optimize adherence and prevention of adverse effects of HAART, one must look for CD4 count at start of therapy and can prevent severe ADR whenever possible and can prevent potentially serious and life threatening events.
Keywords: Highly activated anti retroviral therapy, adverse drug reaction and CD4 count, HIV infection.
Â
Downloads
References
Palella FJ Jr, Delaney KM, Moorman AC, Loveless MO, Fuhrer J, Satten GA, et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. N Engl J Med 1998;338:853-60.
Scaling up antiretroviral therapy in resource limited settings guidelines for a public health approach. Available from: http://www.who.int/hiv/pub/prev_care/ en/ScalingUp_E.pdf. World Health Organization 2002.
d’ArminioMonforteA,LepriAC,RezzaG,PezzottiP,AntinoriA,PhillipsAN,etal. Insights into the reasons for discontinuation of the first highly active antretroviral therapy (HAART) regimen in a cohort of antiretroviral naïve patients: Italian cohort of antiretroviral Naïve patients. AIDS 2000;14:499-507.
Chesney MA, Ickovics JR, Chambers DB, Gifford AL, Neidig J, Zwickl B, et al. Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: The AACTG adherence instruments. Patient Care Committee and Adherence Working Group of the Outcomes Committee of the AdultAIDS Clinical Trials Group (AACTG). AIDS Care 2000;12:255-66.
Ammassari A, Murri R, Pezzotti P, Trotta MP, Ravasio L, De Longis P, et al. Self- reported symptoms and medication side effects influence adherence to highly active antiretroviral therapy in persons with HIV infection. J Acquir Immune Defic SynDr. 2001;28:445-9.
M Kumarasamy P. Balakrishnan et al. Safety, tolerability & effectiveness of locally produced generic antiretroviral drugs in persons with HIV disease in southern India. Int Cong Drug Therapy HIV 2002 Nov 17-21;6:Abstract No-P298.
Sharma A, Vora R, Modi M, Sharma A, Marfatia Y. Adverse effects of anti retroviral treatment. . Indian J Dermatol Venereol Leprol. 2008 May-Jun;74(3):23472.
. Harminder Singh, Navin Dulhani, Pawan Tiwari, Prabhakar Singh, Tiku Sinha: A prospective, observational cohort study to elicit adverse effects of antiretroviral agents in a remote resource-restricted tribal population of Chhattisgarh.Indian journal of pharmacology. 41(5):224-6
Tran C, Knowles SR, Liu BA, Shear NH. Gender differences in adverse drug
reactions. J Clin Pharmacol 1998;38:1003-9. 14. Harris RZ, Benet LZ.
Schwartz JB. Gender effects in pharmacokinetics and pharmacodynamics. Drugs 1995;50:222-39. 15.
LichtensteinKA,DelaneyKM,ArmonC,WardDJ,MoormanAC,WoodKC,etal. Incidence of and risk factors for lipoatrophy (abnormal fat loss) in ambulatory HIV-1-infected patients. J Acquir Immune Defic SynDr. 2003;32:48-56.
Published
How to Cite
Issue
Section
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.