Adverse Effects and Regimen Switch among Patients on Antiretroviral Treatment in a Resource Limited Setting in Ethiopia

Teklay, Gebrehiwot; Legesse, Befikadu; Legesse, Mebratu

doi:10.4172/2329-6887.1000115

Cited by 20 publications

(31 citation statements)

References 16 publications

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“…Studies in Ethiopia, Zambia, and Palmon et al also showed mild liver enzyme elevation in patients initiated on TDF based regimens. 7,9,23 However these findings differ from those of Martinez et al, Sulkowsky, Verucchi et al, Tetrault et al and Manfredi et al, whose incidence of severe ALT elevation were 8% and 17.5% for EFV and NVP respectively. 18,24,25,46,47 A study in Cameroon by Lucien et al found 22.67% (34/150) presented with transaminitis with respect to ALT, 11 , with a study undertaken in the US among 352 subjects found 81 subjects developed elevated liver enzymes over the 96 week follow up period.…”

Section: Discussioncontrasting

confidence: 66%

“…3,4 Recently the test and treat policy has led to a considerable scale up of patients on firstline ART regimens. Unfortunately scale-up of ART exposes some patients to adverse drug reactions (ADRs) [5][6][7][8][9][10] with liver damage characterized by an elevation of alanine aminotransferase (ALT) being the most common. [11][12][13][14] Pharmacovigilance reports in Namibia have shown an increasing incidence in adverse effects that parallel the scale-up of ART, 15 particularly with stratification by CD4 count, [15][16][17][18][19][20] female sex 12,20 and the use of non-nucleoside reverse transcriptase inhibitors (NNRTIs).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Liver enzyme elevations in a cohort of HIV/AIDS patients on first-line antiretroviral therapy in Namibia: Findings and implications

Mataranyika

Kibuule

Kalemeera

et al. 2018

Alexandria Journal of Medicine

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a b s t r a c tIntroduction: All antiretroviral therapies (ARTs) are potentially toxic to the liver. In sub-Saharan Africa, the rising incidence of ART induced adverse events has complicated treatment leading to recent revisions of Namibian ART guidelines. Unfortunately there have been limited studies to date evaluating ART induced liver injury in Namibia to guide further revisions if needed.Objective: Determine the current patterns and grades of ALT elevation in Namibia's HIV/AIDS. Methods: Retrospective cohort analysis. Patterns of alanine amino transferase (ALT) liver enzyme elevation were determined in a cohort of ART naïve HIV patients on firstline ART regimen in a referral hospital in Namibia over a 1 year treatment period. Patterns of ALT changes at baseline, 3 months and 6 months were analyzed using ANOVA and Bonferroni test for pairwise comparisons. Results: Of 79 eligible patients, 72 developed significant ALT elevation within 3 months of ART initiation (F (3, 76) = 6.4, p = 0.002, g 2 = 0.193). Four 4 (5.6%) and 1 (1.38%) patient respectively developed grade 2 and grade 3 ALT elevation by month 3. There was no significant difference between mean ALT levels at baseline and month 6. A CD4 count of <350 cells/mm 3 ; female gender and age over 40 years were the main factors associated with moderate or severe ALT elevation. Conclusions: First line ART commonly induces mild self-limiting liver enzyme elevation in Namibian HIV patients especially in the first 3 months. Consequently, there is a need to monitor ALT levels for at least 3 months after initiation mainly in high risk patients to reduce side-effect concerns. This is already happening. Ó 2017 Alexandria University Faculty of Medicine. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Section: Discussioncontrasting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Liver enzyme elevations in a cohort of HIV/AIDS patients on first-line antiretroviral therapy in Namibia: Findings and implications

Mataranyika

Kibuule

Kalemeera

et al. 2018

Alexandria Journal of Medicine

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“…Senada dengan hasil tersebut, penelitian yang dilakukan Teklay dkk. 10 juga menemukan bahwa 65,5% pasien pernah mengalami efek samping. Efek samping berupa rash, hepatotoksisitas, keluhan gastrointestinal dan sistem saraf pusat (SSP) terjadi di awal pengobatan pada interval paling sering 2 minggu.…”

Section: Pendahuluanunclassified

“…Efek samping berupa rash, hepatotoksisitas, keluhan gastrointestinal dan sistem saraf pusat (SSP) terjadi di awal pengobatan pada interval paling sering 2 minggu. 10 Pada penelitian ini diketahui bahwa efek samping yang paling banyak dialami adalah mual, pusing, gatal dan ruam. Efek samping yang paling sering terjadi adalah terkait sistem saraf pusat yang tidak spesifik sehingga menyebabkan mual, pusing, vertigo dan sakit kepala.…”

Section: Pendahuluanunclassified

Gambaran Efek Samping dan Kepatuhan Terapi Antiretroviral pada Pasien HIV di Rumah Sakit Dr. Hasan Sadikin Bandung tahun 2015

Puspasari

Wisaksana²,

Rovina³

2018

jsk

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Jawa Barat berada dalam posisi 4 besar jumlah kasus baru infeksi HIV terbanyak di Indonesia selama 2012-2014. Pengidap HIV memerlukan terapi Antiretroviral (ARV) agar perkembangan penyakit, komplikasi dan penularannya dapat dicegah. Penelitian ini bertujuan untuk mengetahui gambaran efek samping dan kepatuhan terapi antiretroviral pada pasien HIV berbagai stadium. Penelitian ini merupakan penelitian deskriptif kuantitatif yang dilaksanakan pada September-November 2016. Data sekunder diambil secara restropektif dari 201 rekam medik (total sampling) pasien HIV baru di Klinik Teratai RSUP Dr. Hasan Sadikin periode Januari - Desember 2015. Hasil menunjukkan persentase stadium pasien HIV yaitu stadium 4(41,8%), 1(25,4%), 3(24,9%) dan 2(7,9%). Kebanyakan pasien terdiagnosis dan/atau berobat ketika sakitnya sudah parah atau justru saat screening pada kelompok berisiko. Jumlah pasien yang mengalami efek samping ARV lebih banyak (50,7%) dibanding yang tidak. Efek samping yang paling banyak muncul diantaranya mual, pusing, gatal dan ruam kemerahan pada kulit. Efek samping yang timbul bergantung pada variabilitas kadar ARV dalam plasma. Persentase pasien yang patuh menjalani terapi ARV adalah 58,2%. Tingkat kepatuhan sangat dipengaruhi oleh pengetahuan dan keyakinan akan pentingnya pengobatan. Disimpulkan bahwa efek samping yang timbul bervariasi dan dialami oleh lebih banyak pasien, jumlah pasien patuh menjalani terapi antiretroviral lebih dari setengah total jumlah pasien.Kata kunci: Antiretroviral, Efek samping, Kepatuhan, Pasien HIV, Stadium klinis.

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“…If we also consider the effects of drug therapy in such models, we will be able to introduce the best treatment by simulating the effects of different therapeutic methods. Although antiretroviral therapy has significant effects on prolonging survival of patients, the side effects of long-term applying of these drugs may put the patient at risk [5]. Therefore, in this study, after development of an appropriate model of HIV infection in the peripheral blood stream of patients who are submitted to antiretroviral therapy, a therapeutic schedule is provided that its use causes to a significant decrease in drug dosage.…”

Section: Introductionmentioning

confidence: 99%

Providing a Therapeutic Scheduling for HIV Infected Individuals with Genetic Algorithms Using a Cellular Automata Model of HIV Infection in the Peripheral Blood Stream

Golpayegani¹,

Jafari‬²,

Dabanloo³

2017

JBiSE

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The aim of this study is to develop two-dimensional cellular automata model of HIV infection that depicts the dynamics involved in the interactions between acquired immune system and HIV infection in the peripheral blood stream. The appropriate biological rules of cellular automata model have been extracted from expert knowledge and the model has been simulated with determined initial conditions. Obtained results have been validated through comparing with the accepted AIDS reference curve. The new rules and states were added to the proposed model to show the effects of applying combined antiretroviral therapy. Our results showed that by applying RTI and PI drugs with maximum drug effectiveness, comparing with cases in which no treatment was applied, the steady state concentrations of healthy (infected) CD 4 + T cells were increased (decreased) 53% (41%). Also, the use of cART with maximum drug effectiveness led to a 69% reduction in the steady state level of viral load. At this time, obtained results have been validated through comparing with available clinical data. Our results showed good agreement with both reference curve and the clinical data. In the second phase of this study, by applying genetic algorithms, a therapeutic schedule has been provided that its use, while maintaining the quality of the treatment, leads to a 47% reduction in both drug dosage and the side effects of antiretroviral drugs.

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Adverse Effects and Regimen Switch among Patients on Antiretroviral Treatment in a Resource Limited Setting in Ethiopia

Cited by 20 publications

References 16 publications

Liver enzyme elevations in a cohort of HIV/AIDS patients on first-line antiretroviral therapy in Namibia: Findings and implications

Liver enzyme elevations in a cohort of HIV/AIDS patients on first-line antiretroviral therapy in Namibia: Findings and implications

Gambaran Efek Samping dan Kepatuhan Terapi Antiretroviral pada Pasien HIV di Rumah Sakit Dr. Hasan Sadikin Bandung tahun 2015

Providing a Therapeutic Scheduling for HIV Infected Individuals with Genetic Algorithms Using a Cellular Automata Model of HIV Infection in the Peripheral Blood Stream

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