Although TDF use has been associated with acceptable safety, reports of rare manifestation of renal disease in HAART regimens that include TDF have been documented. The study was conducted at Paballong HIV/AIDS care centre in Berea, Lesotho. The aim of the study was to evaluate clinical outcomes and renal safety in HIV/AIDS patients taking TDFcontaining HAART regimens. Descriptive, observational, longitudinal retrospective design was followed on 255 adults on TDF-containing HAART regimens at the study area; from October 2015 to March 2016. Data captured on a data collection tool included baseline, follow-up and end-line characteristics of clinical outcomes and renal safety. Patients gained an estimated body weight of to 0.10 kg from baseline (p < 0.05) at any age. Females were on average 2.49 kg heavier than males (p < 0.05). The CD4 cell count results estimated a daily increase of 0.20 cells/mm 3 at any age. The mean CD4 cell count of female patients was 69.13 cells/mm 3 higher than for males (p = 0.02). The eGFR results contended that sex, age and body weight are risk factors to developing renal insufficiency. The eGFR declined by 0.78 ml/min/1.73m 2 over the treatment duration at any age of treatment initiation (p < 0.05), while the average eGFR for females was lower (13.05 ml/min) (p < 0.05). Clinical outcomes manifesting by weight gain and CD4 cell count elevation improve at any age and better in females. The renal function is progressively deteriorated at any age and worsened in females.
Pharmacogenomics uses information about a person’s genetic makeup to choose the drugs dosage regimens that are likely to work best for that particular person. The genomic research has changed the “one size fits all” approach and opened the door to more personalized approaches that consider individual genetic makeup tend to enhance the efficacy and safety of drugs; thus saving time and money. Patient DNA influences multiple steps in which the drugs interact with the body and where will the drug act in the body. Genetic makeup-based prescription, design, and implementation of therapy do not only improve the outcome of treatments, but also reduce the risk of toxicity and other adverse events. The aim of the chapter is to explore the documented pharmacogenomics of essential as per pharmacogenomic biomarkers in drug labeling; and suggest efficacy and safety modifications. Polymorphism of drug metabolizing enzymes has the greatest effect on inter individual variability of drug response; affecting the response of individuals to drugs used in the treatment of diseases. Also, genetic deficiency of some enzymes limits effectiveness of drugs in treating concerned diseases. Gene testing prior to initiating concerned treatment is the best clinical practice that to enhance the efficacy and safety of drugs.
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