Adverse effects of antiretroviral treatment.
BACKGROUND
The introduction of highly active antiretroviral therapy (HAART) has led to significant reduction in acquired immune deficiency syndrome (AIDS)-related morbidity and mortality. Adverse drug reactions (ADRs) to antiretroviral treatment (ART) are however, major obstacles in its success.


OBJECTIVE
We sought to study the adverse effects of ART in a resource-restricted setting in India.


METHODS
Hundred patients on ART were studied prospectively over a period of two years. All patients were asked to visit the clinic if they developed any symptoms or on a monthly basis. They were screened clinically and investigated suitably for any ADRs.


RESULTS
Out of the 100 patients, ten patients did not come for follow-up; only 90 cases were available for evaluation. ADRs were observed in 64 cases (71.1%) - the maximal frequency of ADRs was seen with zidovudine (AZT) (50%) followed by stavudine (d4T) (47.9%), efavirenz (EFV) (45.4%) and finally, Nevirapine (NVP) (18.4%). Most common ADRs were cutaneous (44.4%) followed by hematological (32.2%), neurological (31.1%), metabolic (22.2%) and gastrointestinal (20%). Most common cutaneous ADRs observed were nail hyperpigmentation (14.4%) and rash (13.3%). Immune reconstitution inflammatory syndrome (IRIS) was observed as a paradoxical reaction to ART in 20 (22.2%) cases.


CONCLUSIONS
To optimize adherence and thus, efficacy of ART, clinicians must focus on preventing adverse effects whenever possible, and distinguish those that are self-limited from those that are potentially serious.
Sharma
Ajay
A
Department of Skin and VD, Medical College and SSG Hospital, Vadodara, India.
Vora
Roshni
R
Modi
Megha
M
Sharma
Archana
A
Marfatia
Yogesh
Y
D000740:Anemia / Q000139:chemically induced; D044966:Anti-Retroviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003875:Drug Eruptions / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005756:Gastritis / Q000139:chemically induced; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D017495:Hyperpigmentation / Q000139:chemically induced; D054019:Immune Reconstitution Inflammatory Syndrome / Q000139:chemically induced / Q000382:microbiology; D008060:Lipodystrophy / Q000139:chemically induced; D008297:Male; D009260:Nail Diseases / Q000139:chemically induced; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced; D011446:Prospective Studies
D044966:Anti-Retroviral Agents