Adverse effects after HAART Initiation in resource-limited settings: a prospective study from Mysore, India.
BACKGROUND
There are few studies from India documenting the adverse effects of generic HAART (Highly Active Anti-retroviral Therapy).


METHODS
A prospective study was conducted at Mysore, India, to study the adverse effects after HAART initiation in a cohort of 100 antiretroviral therapy (ART)-naive patients, who were evaluated prospectively every three months by clinical and laboratory monitoring for adverse effects after HAART initiation for one year.


RESULTS
The most common first-line regimens were zidovudine (AZT) plus lamivudine (3TC) plus nevirapine (NVP) (42%); followed by Stavudine (d4T) plus 3TC plus NVP  (33%); AZT plus 3TC plus efavirenz (EFV) (13%); and d4T plus 3TC plus EFV (12%). The first-line regimen was modified in14% of patients. The most common reasons for modifying therapy were development of an adverse effect (eight cases; 57.14%) and completion of antituberculous therapy (six cases; 42.86%). The commonest cause for modifying therapy was skin rashes due to NVP (four cases) followed by anaemia two cases) and peripheral neuropathy (two cases). Grade 1 or 2 severity adverse effects by laboratory monitoring were seen in 54 patients after ART initiation and grade 3 or 4 severity adverse effects were seen in eight patients.


CONCLUSIONS
A significant proportion of patients had adverse effects of a lower grade severity after HAART. A significant proportion of those started on ART substitute therapy due to adverse effects and those on NVP-based regimens are more likely to do so when compared with those on non-NVP- based regimens.
Mahathma Gandhi medical college and research institute, Pondicherry, India. rangaraj1980@indiatimes.com
Srirangaraj
S
Sreenivasan
Venkatesha
V
Dasegowda
D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D015331:Cohort Studies; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis; D016568:Drugs, Generic / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1 / Q000187:drug effects; D006801:Humans; D007194:India; D007753:Laboratories; D019829:Nevirapine / Q000009:adverse effects / Q000627:therapeutic use; D011203:Poverty; D011446:Prospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use
D019380:Anti-HIV Agents; D016568:Drugs, Generic; D018894:Reverse Transcriptase Inhibitors; D019829:Nevirapine