Discontinuation and Modification of Highly Active Antiretroviral Therapy in HIV-Infected Ugandans

Kiguba, Ronald; Byakika-Tusiime, Jayne; Karamagi, Charles; Ssali, Francis; Mugyenyi, Peter; Katabira, Elly

doi:10.1097/qai.0b013e31805d8ae3

Cited by 44 publications

(52 citation statements)

References 27 publications

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“…The probable reason is the difference in patient conditions, co-morbid situation or contraindications. Like several other studies (D'Arminio et al, 2000;Dorrucci et al, 2001;Mocroft et al, 2001;O'Brien et al, 2003;Kumara & Vallabhaneni, 2006;Kiguba, 2007;Hart, 2007;Cesar et al, 2010), the most known causes of ARV switching, in the present study, was toxicity with significant heterogeneity in the distribution of adverse events, which is also statistically significant. The patients were with more advanced disease at baseline, which may necessitates higher rates of regimen change/discontinuation due to adverse events.…”

Section: Discussionsupporting

confidence: 56%

“…Cost was one of the major reasons for discontinuation and modification of ARV drugs according to the study conducted in India (Zhon et al, 2010) and Uganda (Kiguba, 2007). But it was not a reason for modification of ARV regimen in our current study due to cost free (fee-free) provision of ARV drugs for the patient in Ethiopia.…”

Section: Discussionmentioning

confidence: 83%

“…This may be explained by differences in primary resistance to NRTIs or NNRTIs containing regimens (Dorrucci et al, 2001). However, some studies have reported higher treatment failure as a reason of regimen switch ( (Kumara & Vallabhaneni, 2006;Hart, 2007;Kiguba, 2007;Mess et al, 2010). In the study in Cote d'lvoire, treatment failure was observed in 12% patient (Keiser et al, 2008) and according to the study in India, treatment failure accounts for 14% of the reasons for modifying therapy (Zhon et al, 2010).…”

Section: Discussionmentioning

confidence: 97%

“…In the study in Cote d'lvoire, treatment failure was observed in 12% patient (Keiser et al, 2008) and according to the study in India, treatment failure accounts for 14% of the reasons for modifying therapy (Zhon et al, 2010). According to a study in Uganda (Kiguba, 2007), immunologic failure alone predicated virologic failure in 56% of patients. This may be due to lack of viral load measuring device and lack of continuous monitoring of patients CD4 count and on occurrence of opportunistic infection in the study setting of this study.…”

Section: Discussionmentioning

confidence: 99%

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Causes for antiretroviral regimen change among HIV/AIDS patients in Addis Ababa, Ethiopia

Jima

Angamo

Wabe

2013

Tanzania J Hlth Res

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Highly active antiretroviral therapy has markedly decreased the morbidity and mortality due to HIV/AIDS. Once antiretroviral therapy (ART) is initiated, patients generally remain on medications indefinitely. A switch in the antiretroviral regimen is often necessary because of both acute and chronic toxicities, concomitant clinical conditions, and development of virologic failure. The objective of this study was to assess the causes of initial highly active antiretroviral therapeutic regimen changes among patients on ART in Addis Ababa, Ethiopia. This was a retrospective cross-sectional study conducted from January 1 to March 1, 2010 in two primary hospitals and one health centre in central Ethiopia. Information cards of HIV/AIDS patients who have had their antiretroviral regimen switched were reviewed. Data from patients below 18 years old and those who did not switch HAART regimen were excluded. Data were then analyzed using SPSS for windows version 16.0. A total of 300 patients' information card was reviewed and the mean age of the patients was 38.6+7 years. Females accounted for 59% (177) of the total patients. The most common first regimen before first switch was D4T/3TC/NVP (63%) and D4T/3TC/EFV (18%). The main reasons for modification were toxicity (65%), comorbidity (25%), pregnancy (5%) and treatment failure (3%). The main types of toxicities observed were peripheral neuropathy (39%), rash (20%) and anaemia (13.33%). Drug toxicity was the main reason for modification of initial antiretroviral regimen and initial Efavirenz-based regimens are less likely to be changed. The occurrence of drug toxicity should be assessed early among patients commencing HAART and health professionals should be empowered to make appropriate regimen changes. ____________________________________________________________________________

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Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Causes for antiretroviral regimen change among HIV/AIDS patients in Addis Ababa, Ethiopia

Jima

Angamo

Wabe

2013

Tanzania J Hlth Res

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“…Similarly, in the study conducted in Coited'lvoire [17] and Uganda [18], it was reported that treatment failure was one of the major reasons for discontinuation and modification of initial regimen.…”

Section: Discussionmentioning

confidence: 99%

The reasons for regimen shift among people living with HIV/AIDS in Asella Referral Hospital

Kasu¹,

Zeleke²,

Gashe³

2017

Med-Science

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Highly active antiretroviral therapy (HAART) is the base for management of patients with HIV infection. On the other hand, a switch in the antiretroviral regimen could be compulsory because of various reasons. Therefore, the aim of this study was to determine the causes for initial antiretroviral regimen switch among adult HIV/ADIS patients. A retrospective cross-sectional study was conducted on patient information records of those visited the ART clinic since February 2013 to January 2015 in Asella Referral Hospital. Results: From 1468 patients' medical information reviewed, 221 of them changed their initial HAART regimens. Among these patients, 38% of them changed their first medications as a consequence of drug toxicity which was mainly triggered by AZT/3TC/NVP. The major cause for changing AZT/3TC/NVP treatment regimen associated with drug toxicity was anemia (17.85%). Other reasons stated for medication shift were co-morbidity, treatment failure, poor adherence and pregnancy. Since most of regimen modifications were in consequence of drug toxicity, these medication shifts require careful patient follow up; frequent laboratory result monitoring and selection of the right antiretroviral regimens.

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Dividuality, masculine respectability and reputation: How masculinity affects men's uptake of HIV treatment in rural eastern Uganda

Siu

Seeley

Wight

2013

Social Science & Medicine

115

156

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Discontinuation and Modification of Highly Active Antiretroviral Therapy in HIV-Infected Ugandans

Cited by 44 publications

References 27 publications

Causes for antiretroviral regimen change among HIV/AIDS patients in Addis Ababa, Ethiopia

Causes for antiretroviral regimen change among HIV/AIDS patients in Addis Ababa, Ethiopia

The reasons for regimen shift among people living with HIV/AIDS in Asella Referral Hospital

Dividuality, masculine respectability and reputation: How masculinity affects men's uptake of HIV treatment in rural eastern Uganda

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