Adverse effects of antiretroviral treatment

Prasad

Int J Basic Clin Pharmacol

et al. 2018

Background: Anti-Retroviral Therapy regimen (ART) is the only treatment option for treating the HIV positive patients for improving the immune system by increasing the CD4 cells. But eventually these medications lead to development of some Adverse Drug Reactions (ADRs) in seropositive patients under treatment.Methods: A prospective observational study was conducted for 6 months from March to August 2018 at ART Centre, Sri Venkateswara Ramnarayan Ruya Government General Hospital (SVRRGGH), Tirupati.Results: Out of 216 ADRs identified, majority where identified in females (54.35%). Most common regimen caused ADR was tenofovir+ lamivudine+ efavirenz (TLE) (55.55%). Data were analysed using the chi-square test were P-value was found to be 0.0024. Majority of ADRs were found in patients of age group between 31-35years was found to be 45 (20.83%) followed by age group between 41-45years was found to be 40 (18.51%). Most of the ADRs were related to central nervous system (27.31%) followed by metabolic disorders (26.38%), hematologic system (23.14%), gastrointestinal system (12.96%), dermatologic system (9.25%), renal system (0.46%) and musculoskeletal system (0.46%). On evaluation of WHO-UMC causality of ADRs, majority were found to be possible (78.7%). The Hartwig and Siegel’s severity assessment scale showed that most of the ADRs were mild (64.42%). The Schumock and Thornton preventability scale showed that 50.92% patients ADRs were probably preventable.Conclusions: As most of the ADRs were observed in patients receiving TLE regimen. So, patients receiving TLE regimen need intensive monitoring. Doctors, nurses, pharmacist must focus on early detection and prevention of ADRs, based on their severity.

contrasting

confidence: 53%

A pharmacovigilance study of antiretroviral therapy in HIV positive out patients at a tertiary care teaching hospital

Prasad

Int J Basic Clin Pharmacol

et al. 2018

“…Hepatitis with raised liver enzymes is also a common manifestation accounting for 22% of the study population. A number of reports documented the incidence of hepatitis 16,17,18,20 due to the use of nevirapine. In our study, it is observed that nevirapine is being taken by 20% of our study population.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2022

IJPSR

The reporting of adverse drug reactions after taking any medicines is very much essential to establish a safe patient profile for drugs. The co-infection of HIV and TB has been a major concern for the healthcare system, and the various drugs interaction from taking ART and ATT should be highlighted to avoid unwanted reactions. The present study was conducted in a hospital set up for a period of one year in the ART center, where the ADR cases were recorded from the HIV patients suffering from tuberculosis. During the study, 135 patients co-infected with HIV and TB were analyzed from which a total 135 adverse drug reactions were collected and recorded. It is observed that rash, raised liver function, fever, peripheral neuropathy, and anaemia are the most common adverse drug reactions from the concomitant therapy of ART and ATT. From the study, 13 different types of ADRs were reported in patients on the ART and ATT therapy. It is important to do the causality assessment according to the WHO-UMC scale of the suspected drug reaction in order to determine whether drug discontinuation is needed or not, as well as to put emphasis on patient education to avoid the same adverse events in the future. INTRODUCTION:Adverse drug reaction is a major health concern for patients across the world. No medicine is devoid of any side effects. The reporting of adverse drug reactions is highly essential as it helps in analyzing the various drug reactions by the regulatory concerns and could help in preparing an effective patient safety profile. WHO defined Pharmacovigilance as the science and activities relating to the detection, assessment, understanding, and prevention of adverse effects or any other possible drugs-related problems 1 .

Globalization and Health

“…It is also well documented that ARTs induce important ADRs in certain individuals, ranging from coetaneous reactions (rash) to severe gastrointestinal or liver reactions [74]. As a consequence, 25% of patients do not adhere completely to their treatment plan, increasing risks of HIV transmission in the general population [74].…”

Section: Discussionmentioning

confidence: 99%

“…As a consequence, 25% of patients do not adhere completely to their treatment plan, increasing risks of HIV transmission in the general population [74]. These variations in individual response to ART are increasingly recognised as being associated with genetic factors [75].…”

Section: Discussionmentioning

confidence: 99%

Pharmacogenomic technologies: a necessary "luxury" for better global public health?

Olivier

Williams‐Jones

2011

BackgroundPharmacogenomic technologies aim to redirect drug development to increase safety and efficacy of individual care. There is much hope that their implementation in the drug development process will help respond to population health needs, particularly in developing countries. However, there is also fear that novel pharmacogenomic drugs will remain too costly, be designed for the needs of the wealthy nations, and so constitute an unnecessary "luxury" for most populations. In this paper, we analyse the promise that pharmacogenomic technologies hold for improving global public health and identify strategies and challenges associated with their implementation.DiscussionThis paper evaluates the capacity of pharmacogenomic technologies to meet six criteria described by the University of Toronto Joint Centre for Bioethics group: 1) impact of the technology, 2) technology appropriateness, 3) capacity to address local burdens, 4) feasibility to be implemented in reasonable time, 5) capacity to reduce the knowledge gap, and 6) capacity for indirect benefits. We argue that the implementation of pharmacogenomic technologies in the drug development process can positively impact population health. However, this positive impact depends on how and for which purposes the technologies are used. We discuss the potential of these technologies to stimulate drug discovery in the case of rare (orphan diseases) or neglected diseases, but also to reduce acute adverse drug reactions in infectious disease treatment and prevention, which promises to improve global public health.ConclusionsThe implementation of pharmacogenomic technologies may lead to the development of drugs that appear to be a "luxury" for populations in need of numerous interventions that are known to have a demonstrable impact on population health (e.g., secure access to potable water, reduction of social inequities, health education). However, our analysis shows that pharmacogenomic technologies do have the potential to redirect drug development and distribution so as to improve the health of vulnerable populations. Strategies should thus be developed to better direct their implementation towards meeting the needs and responding to the realities of populations of the developing world (i.e., social, cultural and political acceptability, and local health burdens), making pharmacogenomic technologies a necessary "luxury" for global public health.