Self-reported adverse reactions among patients initiating antiretroviral therapy in Brazil

Abstract

A cross-sectional analysis was carried out to describe adverse reactions to antiretroviral therapy (ART) reported by HIV-infected patients initiating treatment at two public health AIDS referral centers in Belo Horizonte, Brazil, 2001-2003 and to verify their association with selected variables. Adverse reactions were obtained through interview at the first follow-up visit (first month) after the antiretroviral prescription. Socio-demographic and behavioral variables related to ART were obtained from baseline and follow-up interviews and clinical variables from medical charts. Patients with four or more reactions were compared to those with less than four. Odds ratio with 95% confidence interval were estimated using logistic regression model for both univariate and multivariate analyses. At least one adverse reaction was reported by 92.2% of the participants while 56.2% reported four or more different reactions. Antiretroviral regimens including indinavir/ritonavir, irregular use of antiretrovirals and switch in regimens were independently associated with four or more adverse reactions (OR=7.92, 5.73 and 2.03, respectively). The initial period of ARV treatment is crucial and patients' perception of adverse reactions should be carefully taken into account. Strategies for monitoring and management of adverse reactions including the choice of regimens and the prevention of irregular ART should be developed in AIDS/HIV referral centers in Brazil to promote better adherence to antiretroviral therapy.

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

“…In this study, the prevalence of adverse effect was about 65.5%. A higher prevalence of adverse effects (92.2%) was reported from a study in Brazil [9]. This difference could be due to differences in methodology, where the study in Brazil was based on patient self report and our study was based on patient records which could be affected by adverse effect recording and reporting practice of the health professionals.…”

“…In addition to drug resistance and difficulty of adhering to complex regimens, adverse effects associated with HAART have become a major concern [6]. Inspite of ART benefits, adverse effects to these drugs have been pointed as one of the main reasons for discontinuation, switch and non adherence [7][8][9]. Some clinical outcomes in AIDS patients are difficult to differentiate whether from the disease itself or from ART side effects.…”

Incidencia de reacciones adversas a medicamentos en pacientes que inician o cambian terapia anti-retroviral

“…El motivo más frecuente de cambio de tratamiento en este estudio fue la anemia 13,2% (n: 10) del total de eventos adversos pesquisados. Otros estudios han publicado una incidencia de anemia asociada a AZT que oscilan entre 10 y 35%, sin dejar de lado que existen factores inmunológicos, virológicos y características propias de los pacientes, que inciden en la aparición de estas alteraciones [11][12][13][14] . Por otro lado, la Cohorte Chilena de SIDA ha informado como causa de cambio o suspensión del tratamiento por toxicidad, las anemias constituyendo el 9,9% 15 .…”

Adverse Drug Reactions to Antiretroviral Therapy in HIV-Infected Patients at the Largest Public Hospital in Nicaragua

“…[1][2][3][4][5][6][7] It has been shown that ADRs are associated with nonadherence to treatment, discontinuation of ART, treatment failure, and changes in ART regimens. [8][9][10][11][12][13] Understanding the frequency and distribution of ADRs among HIV-infected patients is imperative to optimally manage their disease, given the significant consequences of ADRs in this patient population.…”