Motives for change of first-line antiretroviral therapy regimens in an unselected cohort of HIV/AIDS patients at a major referral centre in South-west Cameroon

Abstract

ObjectiveThe rapid scale-up of antiretroviral therapy (ART) coverage in sub-Saharan Africa has encountered the challenge of maintaining international clinical standards of ART utilization and change of ART regimens. In Cameroon, scarce reports have documented the motives for change of ART. This study had as objective to investigate the reasons for switch in ART through a secondary analysis and descriptive synthesis of data from a cross-sectional study at the Limbe Regional Hospital.ResultsOne hundred participants were included. Their mean age was 40.2 ± 8.0 years and 70% of them were females. The median duration of ART use was 60 months. Zidovudine-Lamivudine-Nevirapine regimen was received by 83% of patients while the Stavudine-Lamivudine-Nevirapine regimen had the highest median duration of use (58 months). Most patients had experienced changes in ART (especially from Stavudine-Lamivudine-Nevirapine regimen) with the chief reason being unavailability of their previous regimens. Four patients had their ART changed due to active tuberculosis, 4 due to pregnancy and 7 due to ART toxicity (4 and 3 for peripheral neuropathy and lipodystrophy respectively). In conclusion, shortages in ART hugely influenced switch in regimens. In such a context, modifications in ART possibly deviate from guidelines with resultant sub-optimal therapy and enhanced drug resistance.Electronic supplementary materialThe online version of this article (10.1186/s13104-017-2948-3) contains supplementary material, which is available to authorized users.

Pattern of and reasons for antiretroviral therapy regimen change among adult HIV/AIDS patients at regional hospital in Eastern Ethiopia: A 10-year retrospective study

“…Studies reported that the majority of patients presented to the healthcare settings when the disease had become advanced (WHO clinical stage III). 11,18,19,22 In concordant to our finding, study done in Tikur Anbesa Specialized Hospital (TASH) also indicated that the mean weight of the patients during initiation of ART was 55.6(±10) kg and four-fifths of patients had a CD4 count of less 200 cells/mm 3 at the baseline. 18…”

“…In line with the present finding, several studies indicated that among patients who had their treatment changed for the first time, the majority was female. 3,4,11,18–20 This might be due to the fact that the higher proportion of female patients who initially started ART and the increased likelihood of regimen change among female for specific reasons such as pregnancy. Looking at the age distribution of patients included in various studies, the mean ages of the participants were 40.2 (±8.0) years in major referral hospital of Southwest Cameroon, 11 38.6 (±7.0) years and 36.5 (±8.9) years in health facilities of Addis Ababa, Ethiopia.…”

“…3,4,11,18–20 This might be due to the fact that the higher proportion of female patients who initially started ART and the increased likelihood of regimen change among female for specific reasons such as pregnancy. Looking at the age distribution of patients included in various studies, the mean ages of the participants were 40.2 (±8.0) years in major referral hospital of Southwest Cameroon, 11 38.6 (±7.0) years and 36.5 (±8.9) years in health facilities of Addis Ababa, Ethiopia. 3,18 Similarly, the age ranges of majority of patients were 20–34 years in Oromia Regional State, Ethiopia; 19 31–45 years in Tikur Anbesa Specialized Hospital, Ethiopia; 18 and 30–44 years in regional hospital of KwaZulu-natal, South Africa.…”

Prevalence and risk factors of metabolic syndrome in HIV‐infected adults at three urban clinics in a post‐conflict setting, eastern Democratic Republic of the Congo

“…Our findings have several clinical and public health implications. As seen in other studies in Africa [27,29,49], PLHIV are younger and facing the additional burden of non-communicable diseases. There is an urgent need to implement CVD prevention and management strategies in HIV-infected patients.…”

“…Also, despite specific WHO guidelines on how to manage such chronic conditions in PLHIV, their implementation remains challenging in most African countries. For example, recent studies are still reporting the use of stavudine‐based regimens, prescribed due to shortages of safer ART despite their association with cardiometabolic abnormalities . Furthermore, there are scarce data on the burden of dyslipidaemia, CVD and MS in HIV‐infected adults and association with ART in resource‐limited settings, including the Democratic Republic of the Congo (DRC) .…”