Pharmacoepidemiology of antiretroviral drugs in a teaching hospital in Lagos, Nigeria

Abstract

SUMMARYObjective: Prescribing, adherence, and adverse drug events to HAART in a large antiretroviral programme in Lagos was evaluated. Design A retrospective 5 year open cohort study Setting The AIDS Prevention Initiative in Nigeria (APIN) clinic at LUTH is one of the United States Presidential Emergency Plan for AIDS Relief (PEP-FAR) funded centers for HIV relief program in Nigeria Participants The case files of 390 patients on HAART and attending the APIN clinic were reviewed sequel to random selection. Main outcome measures: Demographics of the patients and pattern of antiretroviral (ARV) combination drugs prescribed were extracted from their case files. The details of the adverse drug events (ADEs) were extracted from drug toxicity forms regularly filled for each patient. A Chi-square test with Yates correction was used to determine the association between adherence and therapeutic outcome Results A total of 2944 prescriptions were assessed. Zidovudine + lamivudine + nevirapine (35.87%) and stavudine + lamivudine + nevirapine (35.63%) were the most frequently prescribed combinations. Over 2000 ADEs were reported with cough (13.3%), fever (8.75%) and skin rashes (8.01%) being the most frequently reported. Drug adherence was associated with good therapeutic outcome (χ2 = 115.60, p<0.0001). Conclusions: Zidovudine + lamivudine + nevirapine was the most frequently prescribed ARV combination. Cough was the most frequently reported ADE. Interventions aimed at rational prescribing of ARV drugs and improving adherence to antiretroviral drugs is essential for good therapeutic outcome in the treatment of HIV infection.

Current trends in highly active anti-retroviral therapy in an anti-retroviral therapy centre attached to a remote government medical college of Maharashtra, India: a retrospective study

“…In the present study, zidovudine+lamivudine+nevirapine (ZLN) (86.75%) were the most commonly prescribed HAART combination followed by tenofovir+lamivudine+ effavirenz (TLE) (36.42%) and stavudine+lamivudine+nevirapine (SLN) (34.44%). Similar results were found in Jiyo C et al and Oreagba A. et al 16,1 The most common regimen prescribed among the first line HAART was the combination of zidovudine+lamivudine+nevirapine (26.76%) followed by stavudine+lamivudine+nevirapine (10.53%). The above findings is in accordance with our national guidelines for antiretroviral therapy which recommends ZLN as the first choice and SLN as second choice among all first line HAART regimens.…”

“…Similar results were found in a study conducted by Oreagba IA et al In that study 63% patients were married and 24% patients were single. 1 In the present study, most common mode of transmission of HIV/AIDS infection was by heterosexuality in 94.04% of the patients. Other modes were probable unsafe injection (1.99%), mother to child (1.99%) and blood transfusion (1.32%).…”

“…These findings are similar to a study conducted by Oreagba IA et al in Nigeria who found 67% of the patients were illiterate and low education background. 1 This shows there is ignorance and lack of knowledge and education regarding the HIV/AIDS infection. So it is necessary to conduct mass educative programs to create awareness about the disease, its mode of transmission, the risk behaviour among sexually active age group and its preventive measures.…”

“…It may derail socio-economic development because of its huge influence on family stability, life expectancy and economic development. 1 Today, around 4.87 million people are living with HIV in South, East, and South-east Asia. In India, an estimated 0.1% of adults aged 15-49 years are living with HIV; however, with a population of around 1 billion, this actually equates to 2.3 million adults living with HIV in India.…”

Lamivudine’s hypersensitivity in an HIV infected patient: case report

“…4 Devido a essa característica de segurança farmacológica, consiste no medicamento mais utilizado em esquemas de terapia antirretroviral, além de não ter interação com outros antirretrovirais. 4,5,6 Outro benefício do uso deste medicamento é que a mutação relacionada à resistência a esta droga (M184V) reduz o fitness viral, sendo considerado benéfica a manutenção do medicamento mesmo em pacientes com a resistência à lamivudina. 7 O objetivo deste relato é descrever um caso de reação de hipersensibilidade grave a um fárma-co de ampla utilização e que é considerado seguro.…”