Antiretroviral-induced adverse drug reactions in HIV-infected patients in Mali: a resource-limited setting experience

Abstract

Background: There are few reports in the literature from sub-Saharan Africa (SSA) regarding antiretroviral-induced adverse drug reactions (ADRs). Antiretroviral therapy (ART) is now widely available in SSA, and ADRs during HIV infection are also frequent. In this study, we reported the frequency and risk factors of ART-induced ADRs in a Malian population. Methods: This prospective cohort study was performed in the HIV Care and Counseling Centre (CESAC) of Mali from 2011 to 2012. Adult patients infected with HIV and who had recently started ART were included and followed-up clinically Were included in this study, adult patients living with HIV and had recently started ART who were followed up for at least 6 months to determine the incidence of ADRs using Naranjo’s classification scale. Results: During this study, 357 (42.3%) patients presented ADRs (40.1% of our patients (n=338) experienced at least one ADR, and 2.2% (n=19) experienced at least two ADRs). The prevalence of ADRs by organ system was: 45.9% neurological (n=164); 29.4% metabolic (blood chemistry) (n=105); 15.4% hematological (n=55). High probable rate of ADR was observed as indicated by the Naranjo score in 83.7% of the cases. Zidovudine (AZT) and stavudine (d4T) use was identified as a risk factor for either anaemia or peripheral neuropathy whereas nevirapine (NVP) and female gender were risk factors for skin reactions. Patients with advance disease had the highest rate of ADRs compared to the others. Conclusions: Based on the Naranjo probability scale, our data show that ADRs such as peripheral neuropathy and anemia are very frequent. These ADR was linked to AZT and D4T. Our findings highlight the need for active monitoring, continuous pharmacovigilance of ART and change of some ART drug in this population.

Knowledge, attitudes and practices of health care professionals towards adverse drug reaction reporting in public sector primary health care facilities in a South African district

“…Adverse drug reactions (ADRs) are a major public health problem that causes increased mortality, morbidity and costs, including increased hospital admissions and length of stay [1][2][3][4][5][6][7][8][9]. Physicians, pharmacists, dentists and nurses are in a position to play a key role in pharmacovigilance programmes; however, under-reporting of ADRs is common across countries especially in low-and middle-income countries (LMICs) [10][11][12][13][14][15][16][17][18].…”

Variation of adverse drug events in different settings in Africa: a systematic review

“…In addition, 38 studies [ 45 – 50 , 52 , 54 – 64 , 66 – 74 , 76 , 78 , 79 , 82 – 84 , 89 , 90 , 92 – 94 ] reported the occurrence of ADEs in the outpatient setting, and four studies [ 53 , 75 , 77 , 81 ] reported ADEs in the community setting. Majority of included studies [ 18 – 22 , 27 – 29 , 32 – 34 , 36 , 37 , 40 , 41 , 43 , 45 – 48 , 52 , 54 – 60 , 62 – 65 , 67 , 70 , 72 – 74 , 76 , 79 , 81 , 82 , 89 , 90 , 92 – 94 ] were carried out on adult population (aged ≥ 18 years) ( n = 46), while 18 studies were conducted among all age groups (aged 0–100 years) [ 23 , 24 , 30 , 50 , 51 , 61 , 66 , 68 , 69 , 71 , 75 , 77 , 78 , 84 – 88 ], 12 studies [ 25 ...…”

Adverse reactions and cardiac arrhythmias related to antiretroviral use in patients with HIV/AIDS

“…The EFV/AZT/3TC scheme was associated with an increased risk of cardiovascular events OR1 6; 95% CI: 1.25-2.04 (54). 19 The EFV/AZT/3TC scheme was associated with an increased risk of cardiovascular events OR1 6; 95% CI: 1.25-2.0419. 19 Our series coincides in aspects such as the use of antiretrovirals such as AZT and 3TC, which could explain the frequency of arrhythmias, facts such as knowledge of this phenomenon implies making therapeutic readjustments for a better comprehensive therapeutic approach.…”

“…19 The EFV/AZT/3TC scheme was associated with an increased risk of cardiovascular events OR1 6; 95% CI: 1.25-2.0419. 19 Our series coincides in aspects such as the use of antiretrovirals such as AZT and 3TC, which could explain the frequency of arrhythmias, facts such as knowledge of this phenomenon implies making therapeutic readjustments for a better comprehensive therapeutic approach. However, Hunt et al 20 in a review of the literature published in MEDLINE and EMBASE up to August 2011, conclude that the use of protease inhibitors (PI) does not seem to be an independent predictor of QT interval prolongation as dangerous arrhythmias.…”