Adverse Events in HIV- infected Children on Antiretroviral Therapy at a Teaching Hospital in Lagos, Nigeria: A Retrospective Study

Abstract

Background: Highly active antiretroviral therapy (HAART) program requires adequate monitoring of the potential adverse events to the antiretroviral (ARV) drugs. We investigated the ARV drug combinations prescribed for HIV-infected children and their suspected adverse events.Methods: This is a retrospective and descriptive study involving HIV-infected children less than 15 years old who received treatment at the APIN clinic, Lagos University Teaching Hospital (LUTH) in Nigeria. The case files of 80 patients initiated on HAART, between January 2008 and December 2009, were reviewed. Their demographics, clinical details and medication use, the prescribed HAART regimen, and the suspected clinical and laboratory adverse events were extracted. Results:The patients were female (46; 57.5%) preponderant with a median age of 3 (IQR: 1.1-6.0) years. Zidovudine-lamivudine-nevirapine (AZT-3TC-NVP) combination (74; 92.5%) was the most frequently prescribed first-line regimen. Thirty three patients changed their first-line HAART to abacavir-lamivudine-lopinavir boosted with ritonavir (ABC-3TC-LVP/r) (11; 33.3%), and zidovudine-lamivudine-abacavir-lopinavir boosted with ritonavir (AZT-3TC-ABC-LVP/r) (8; 24.2%) combinations. Of the 80 patients included in the study, 38(47.7%) experienced 142 adverse events. The most frequently experienced clinical adverse events were nevirapine-induced skin rashes (93; 65.5%), vomiting (19; 13.4%), and pallor (12; 8.5%). Macrocytosis (22/72; 30.6%), anaemia (6/72; 8.3%), and thrombocytopenia (2/72; 2.8%) were the commonest haematological adverse events associated with zidovudine. Conclusions:The HAART regimens used for HIV-infected children in this study have a good safety profile. Their few adverse events suggest a need for prospective pharmacovigilance to effectively monitor the toxicities of ARV drugs.

Magnitude and associated factors of peripheral cytopenia among HIV-infected children attending at University of Gondar Specialized Referral Hospital, Northwest Ethiopia

“…The most common reasons being thrombocytopenia was, peripheral destruction of platelets due to crossreactivity of HIV antibodies, apoptosis of megakaryocytes due to direct HIV infection and abnormal and dysfunctional platelet production [54]. The prevalence was similar with a finding reported by Oshikoya et al [55] found to be 1.4%. However, this is lower than the prevalence 11.4% reported in DASH Lafia, Nigeria [48] and 11% in India [31].…”

Off-label use of pentazocine and the associated adverse events among pediatric surgical patients in a tertiary hospital in Northern Nigeria: a retrospective chart review

“…Although rare AEs to pentazocine have not been reported in children, myofibrosis and its calcified form had been reported in adults following prolonged use of high-dose pentazocine [22,23]. Other rare AEs reported in adults include fibrosis at the injection site [24], irregular punched-out abscesses with a rim of hyper-pigmentation surrounding the ulcer [25,26], bilateral deep vein thrombosis, toxic epidermal necrolysis, generalized erythematous desquamative rash [27], fibromyositis and contracture [28].…”

“…: Types of surgery necessitating the use of pentazocine Note: * represents exploratory laparotomy with some specific procedures including wedge resection of the bowel and repair (28), manual reduction of intussusceptions only (26), bowel resection and anastomosis (15), excisional biopsy (7), hemicolectomy (6), appendectomy (4), bowel resection and loop colostomy (3), and manual reduction of intussusceptions with appendectomy (2).…”