title: Hospitalization due to adverse drug reactions and drug interactions before and after HAART.
abstract: OBJECTIVE
  To characterize and compare the rates of adverse drug reactions (ADRs) and interactions on admission in two, one-year periods: pre-highly active antiretroviral therapy (HAART) (phase 1) and post-HAART (phase 2).
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  University-affiliated tertiary care centre.
  
  
  METHODS
  HIV-positive patients admitted to hospital.
  
  
  RESULTS
  In phase 1, 436 of 517 admissions, and, in phase 2, 323 of 350 admissions were analyzed. Over 92% of patients were male, with a mean age of 38 years. Significant differences (P<0.05) in the mean length of stay (12.08 versus 10.02 days), the CD4 counts (99.25 versus 129.45) and the number of concurrent diseases (4.20 versus 3.63) were found between phase 1 and 2, respectively. The mean number of medications taken (5.52 versus 5.94) and the rates of hospitalization with ADRs (20.4% versus 21.4%) or interactions (2.5% versus 2.16%) were similar between the two phases. Antiretrovirals were more common in ADR admissions post-HAART (21.3% versus 36.2%), while antiparasitics, psychotherapeutics and antineoplastics were more common pre-HAART. Other classes of drugs involved in both phases were sulphonamides, narcotics, ganciclovir, foscarnet, antimycobacterials and antifungals. ADR causality was possible or probable in more than 80% of cases. Over 60% of ADRs were grades 3 to 4, and about 85% were either the main or contributing reason for admission. About 65% of patients had at least partial recovery at the time of discharge. In phases 1 and 2, 8.9% and 2.9% of admissions,respectively, with ADRs were fatal.
  
  
  CONCLUSIONS
  Although hospitalizations with ADRs and interactions were similar in both phases, HAART therapy has had a significant impact on the incidence and nature of ADRs at St Michael's Hospital, Wellesley Central Site, Toronto, Ontario.
authors.affiliation: St Michael's Hospital, The Wellesley Health Centre and University of Toronto, Ontorio.
authors.forename: M M
authors.initials: MM
authors.lastname: Foisy
authors.forename: K
authors.initials: K
authors.lastname: Gough
authors.forename: C M
authors.initials: CM
authors.lastname: Quan
authors.forename: K
authors.initials: K
authors.lastname: Harris
authors.forename: D
authors.initials: D
authors.lastname: Ibanez
authors.forename: A
authors.initials: A
authors.lastname: Phillips