Background: Much progress has been made in treating HIV infection in the last several years and currently antiretroviral therapy regimens are capable of reducing viral load of undetectable level with a consequent increase in T-lymphocyte, CD4+ counts and reduction in development of opportunistic infections. Hence, a substantial reduction in HIV associated morbidity and mortality can be attained. In spite of antiretroviral therapy benefits, adverse reaction to these drugs has been pointed to as one of the main reason for discontinuation, switch and non adherence to antiretroviral therapy. Methods: A cross-sectional retrospective review of patient record from December 2009-Novomber 2012 was performed to determine the common adverse drug reactions in patients taking ART medications. A sample of 154 who were taking ART medications at Ambo Zonal Hospital was studied and SPSS for windows software versions-16.0 was used for data analysis. Results: A total of patients with average age of 32.5 years who are taking ART drugs for more than 6 months were studied for the prevalence of adverse reactions. The frequency of GI tract adverse reactions were found to be 75 (48.7%) followed by CNS adverse effects, 55 (35.7%) skin reactions accounted for 29 (18.8%). The least frequently occurred adverse reactions were hematologic reaction (anemia). Patients with low BMI (OR =4.09, p=0.000), having comorbidities (OR=4.566, p=0.000), low CD4+, p=0.002) and treated by TDF/3-TC/EFV (OR=2.087, p=0.001) had high risk of developing adverse drug recreations. Conclusions: BMI, the presence of other diseases, types of regimen used, duration of therapy and CD4+ lymphocyte less than 400cell/mm3 were strongly associated with the occurrence of adverse drug effects in this study. [Int J Basic Clin Pharmacol 2013; 2(2.000): 208-215
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