A 33-year-old patient with human immunodeficiency virus on antiretroviral therapy with efavirenz-induced complex partial seizures: a case report

Abstract

BackgroundEfavirenz is a commonly prescribed antiretroviral drug that is largely well tolerated. However, seizure disorder is a rare side effect. Prompt identification and immediate replacement of efavirenz with an alternative drug would effectively stop the seizures. To the best of our knowledge, we present the first reported case in the literature of complex partial seizures arising due to efavirenz.Case presentationWe report a case of a 33-year-old Nigerian man treated with an efavirenz-based antiretroviral regimen for human immunodeficiency virus infection. He presented with seizures soon after commencement of antiretroviral drugs. His magnetic resonance imaging results were unremarkable. His blood levels of sodium, glucose, urea, and creatinine were within normal limits. However, his electroencephalogram showed intermittent bursts of high-voltage sharp waves and spikes bilaterally over frontotemporoparietal regions, a finding consistent with complex partial seizures. His efavirenz plasma level was 209.55 μg/ml. His seizures stopped following a switch to a non-efavirenz-based regimen.ConclusionsThis report brings to light the occurrence of complex partial seizures in patients on efavirenz. It also demonstrates the effective resolution of seizures when efavirenz treatment is replaced with a non-efavirenz-based regimen.

Addressing the under-reporting of adverse drug reactions in public health programs controlling HIV/AIDS, Tuberculosis and Malaria: A prospective cohort study

“…Public health programs, especially the HIV/AIDS, Tuberculosis and Malaria have the greatest risk of ADRs because millions of people are treated with a wide range of drugs, some of which have serious/life threatening adverse reactions [ 35 – 38 ]. In the western countries where ARVs have been used for many years, cases of rising obesity, weight gain and cardio-metabolic diseases are persistently being reported in association with the use of ARVs [ 39 – 40 ].…”

“…Until the SPHAR-TI course, majority (71.0%) of the healthcare workers that participated in the course have never received training in pharmacovigilance but were nonetheless working in public health institutions or hospitals directly treating HIV/AIDS, Tuberculosis and Malaria through the respective public health disease control programs. Some studies have reported high prevalence of ADRs emanating from the HIV/AIDS, TB and Malaria public health programs [ 13 , 35 , 37 , 38 , 39 , 40 ], thus, justifying the SPHARTI model.…”