Antiretroviral Durability and Tolerability in HIV-Infected Adults Living in Urban Kenya

Abstract

Excellent clinical and immunologic responses to ART were observed in this urban Kenyan population; however, frequent switches in ART among medication classes because of toxicity or drug interactions may limit the durability of these responses.

Prevalence of adverse drug reactions in adult patients on anti-retrovirals at Kenyatta National Hospital, Comprehensive Care Centre

“…This is not surprising because a reduced occurrence of rashes has been noted in Africa for other medications like cotrimoxazole (21). Our findings are similar to those obtained in several other studies in Africa; the study in rural Uganda also reported a low frequency of rash (6%) (14) while rashes occurred in approximately 3.7% of patients in the St Mary's (Kenya) study (15). This may partly be explained by the fact that it is much harder to see rashes on the dark skin of Africans compared to the lighter skin of Asians.…”

“…In our study, hepatoxicity occurred in approximately 4% of patients, which is higher rate than among several cohorts in resource-limited settings. The Uganda and Kenya studies reported a frequency of acute hepatitis of 0.5% and 0% respectively (14,15). The difference could be because these two studies reported only acute cases.…”

“…The study in South India reported that clinically significant anaemia was observed in 5.4% of patients (25), while the study in rural Uganda reported an even lower frequency of 0.4% (15).…”

“…This was consistent with findings from several other studies in resource-limited settings. In the two studies carried out at rural Uganda and St Mary's hospital in Nairobi, peripheral neuropathy was reported most frequently with a prevalence of 36% and 20.7% respectively (14,15). Peripheral neuropathy was also the most common ADR in a cross-sectional study involving 720 patients in a large teaching hospital in Malawi (16).…”

Implementation of a Validated Peripheral Neuropathy Screening Tool in Patients Receiving Antiretroviral Therapy in Mombasa, Kenya

“…2 Recent studies from sub-Saharan Africa have found PN to be the most common side effect (range = 4.3-56%) in patients receiving D4T-based antiretroviral therapy (ART). [3][4][5][6][7][8][9] However, none of these studies were conducted using a validated screening tool for PN designed for use by general practitioners. We implemented a validated Brief Peripheral Neuropathy Screen (BPNS) for patients receiving ART to assess the feasibility of using this tool in routine care and to determine the prevalence of PN in our outpatient clinic population in Mombasa, Kenya.…”