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

Abstract

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.

Magnitude and causes of first-line antiretroviral therapy regimen changes among HIV patients in Ethiopia: a systematic review and meta-analysis

“…Four studies were done on children [27–30] and thirteen studies were done on adult participants [15, 31–42]. Four studies had included all the age ranges [43–46].…”

“…Out of the 22 articles included in this review, 14 articles reported the magnitude of regimen change, varying from 15% [43] to 64% [45]. The sample size ranges from 225 [27] to 4809 [37] patients.…”

“…Out of the 22 articles included in this review, 17 articles reported the causes for first-line ART regimen change. Out of the 17 articles, 12 articles mentioned drug toxicity, as a cause for a regimen change [15, 29, 31, 33, 34, 36, 39, 41, 43–46], three articles described it as a side effect [27, 28, 32], one article describes the reason as adverse drug reaction (ADR) [38]. In this systematic review, the causes described as a side effect, hepatotoxicity and ADR were categorized under toxicity.…”

“…Out of the 17 articles included in the assessment of the causes of magnitude change, 13 articles described pregnancy [15, 31–34, 36, 38, 39, 41, 43–46]. Fourteen articles described treatment failure [15, 28, 31–34, 36, 38, 39, 41, 43–46], two studies mentioned clinical failure [28], and virological failure [32] as a cause. Out of the 17 articles included in the assessment of the causes of magnitude change, only one article didn’t mention TB co-morbidity as a cause [40].…”

Magnitude of antiretroviral treatment failure and associated factors among adult HIV-positive patients in Harar public hospitals, Eastern Ethiopia

“…The sample size was estimated using single population proportion formula by considering the prevalence of ART failure (37%) from the previous study conducted in Asella Referral Hospital, 8 with 95% confidence interval and 0.03 degree of precision. The final sample size including 10% non-response rate was 1094.…”