STUDY OF ADVERSE EFFECT OF DRUGS  DUE TO ANTIRETROVIRAL THERAPY IN  PATIENTS OF HIV INFECTION

Dr Madhuri Wahane; Dr P.Patil sir; Dr Arun Janbandhu

Volume : V, Issue : IV, April - 2016

STUDY OF ADVERSE EFFECT OF DRUGS DUE TO ANTIRETROVIRAL THERAPY IN PATIENTS OF HIV INFECTION

Dr Madhuri Wahane, Dr P. Patil Sir, Dr Arun Janbandhu

Abstract :

Highly ative antiretrovi ral therapy (HAART ) is effective in reducing the plasma viral load,has dramatically reduced the morbidity and mortality associated with human immunodeficiency virus (HIV) infection and has improved the prognosis for people living with HIV infection/AIDS (PLHA)8–10. . In recent years, excitement about the benefits of antiretroviral therapy and side effects associated with highly active antiretroviral therapy has become a major concern. The present study has been undertaken to study the adverse effects and frequency of adverse effects of first line antiretroviral drug The present study was conducted in ART centre of our parent institution .It was a prospective observational study.130 HIV–1/AIDS patients eligible for first line antiretroviral therapy as per NACO guidelines filtered through following criteria, either hospitalized or coming to ART clinic were included in the study. The observations of our study are as follows. Total 130 patients were studied, 92(70.76%) were males and 38(29.23%) were females. The most common mode of transmission of HIV–1 infection was heterosexual, 125 patients (96.15%),homosexual 2(1.53%),blood transfusion 2(1.53%)and IV drug user 1(0.76%). Most of the patients were in WHO stage III,74 patients(56.92%),followed by stage II ,30 patients(23.07%),stage IV,20 (15.38%)and stage I,6 (4.61%). Most of the patients were having CD4 count between 101–200/mm3, 71 patients (54.67%). Most commonly used initial ART regimen was Zidovudine + Lamivudine + Nevirapine ,83 patients (63.84%)received this regimen as initial regimen. Most common adverse drug effect due to ART observed was gastrointestinal disturbances like nausea, vomiting, diarrhoea observed in 39 (30%) patients. Second most common adverse drug effect was anaemia seen in 32 patients (24.61%). Hepatotoxicity and skin rash seen in 19(14.61%), 14(10.76%) patients respectively. 7 patients(5.38%)had neuro psychiatric complaints. Peripheral neuropathy 6 (4.61%) and lactic acidosis was seen in 3 (2.30%) patients receiving ART. Steven Johnson�s syndrome/Toxic epidermal necrosis and lipodystropy were observed in 3(2.30%) and 2 (1.53%)patients respectively. 2 patients of lactic acidosis and 2 patients stevens johnsons syndrome died and death was attributed to adverse effect. Overall, 40 patients required change in the initial HAART regimen,37(28.46%) were due to drug toxicity while only 3 (2.30%) were due to tuberculosis. Out of 37 patients who required change in the initial HAART therapy due to drug toxicity, 4 patients died and these deaths were attributed. 25 (30.12%) patients out of 83 patients who received Zidovudine+lamivudine+nevirapine as initial regimen required to change the regimen due to adverse effects. 9 patients (39.13%) had to change the initial regimen of Stavudine+lamivudine+nevirapine . Out of 21 patients who received Zidovudine+lamivudine+efavirenz as initial therapy , 2 patients(9.52%) required to change the therapy. 1 patient required to change the therapy due to adverse drug effect of Stavudine+lamivudine+efavirenz regimen.