Adverse drug reactions to antiretroviral therapy during the early art period at a tertiary hospital in Ghana

Abstract

IntroductionAntiretroviral therapy (ART) has reduced HIV morbidity and mortality worldwide but has many adverse effects. These adverse drug reactions (ADRs) lead to discontinuations, disease progression or treatment failure. We explored the types and risk factors for ADRs in a cohort starting ART in a teaching hospital in Accra, Ghana where the main regimens used were a combination of nucleotide and non nucleotide reverse transcriptase inhibitors.MethodsA Cross-sectional retrospective study was conducted reviewing data of 2042 patients initiated on HAART from 2003 to 2007. Univariate analysis was done for the dependent and independent variables. Stepwise logistic regression procedures were used to model the effect of gender on the development of ADRs controlling for other variables like age, marital status, weight at baseline and CD4 at baseline.ResultsThe period prevalence of ADRs was 9.4%. The two most common adverse reactions were anaemia and diarrhoea. Female sex was a statistically significant independent predictor of an adverse drug reaction (AOR: 1.66, p = 0.01, CI: 1.16-2.36). CD4 counts 250 cells/mm3 or more was significantly associated with the occurrence of an ADR. The occurrence of anaemia in females was statistically significant compared to males.ConclusionAdverse drug reactions were less common than expected, anaemia was the commonest ADR. Female sex and high CD4 counts >250mm3 were predictors of ADRs whereas females were significantly more likely to develop anaemia than males. Recommendations were made for interventions to prevent and also mitigate the high levels of anaemia especially among women in the ART scale up.

Incidence and Predictors of Sever Adverse Drug Reactions Among Patients on Antiretroviral Therapy at Debre Markos Referral Hospital, Northwest Ethiopia

“…About 13.81% (95% C.I: 10.87%, 17.2%) of the cohort had experienced ADR. This figure is higher than findings from Bahir Dar city (10%) [13], a tertiary hospital in Addis Ababa (7.7%) [17], seven teaching hospitals in Ethiopia (9.5%) [14], Nigeria (1.4%) [15,16], a tertiary hospital in Ghana (9.4%) [18] and India (2.4%) [19]. The difference might be due to the longer follow up time in the current study which can be explained by the longer the follow-up, the higher the probability of including the ADR [21] and Kenya where it accounted for 66.3% [22].…”

Adverse drug reaction in HIV-infected people treated with HAART in Maringá, Southern Brazil

“…This is consistent with research conducted in Ethiopia and Ghana [21,4]. In contrast to these findings, a study in HIV infected patients at an ART Centre of tertiary care hospital in India showed a higher prevalence in males than in females [22].…”

“…The occurrence of ADRs may negatively affect the quality of life of patients as well as adherence to the treatment. The spectrum of adverse events is wide and varied, being difficult to identify the principal cause [4]. b The percentages in these columns represent the percentage of all patients with the specific adverse drug reactions.…”

Adverse Drug Reactions to Antiretroviral Therapy (ART): Prospective Study in HIV Infected Adults in Sikasso (Mali)

“…The sample consisted predominantly of women with an average age of 36.3 years versus 33.5 years. In Ghana, Lartey et al found a female predominance in their study [16]. This female predominance can be explained by the frequency of heterosexual transmission and the biological vulnerability of women with a larger contact area and a longer time.…”