title: Pharmaceutical care outcomes in an outpatient human immunodeficiency virus treatment center in Jos, Nigeria.
abstract: BACKGROUND
  Pharmacotherapy for patients infected with human immunodeficiency virus (HIV) is complex and increases the potential for drug therapy problems (DTPs). We described the frequency and type of DTPs in a Nigerian cohort of HIV infected patients on antiretroviral therapy (ART), as well as the changes in HIV clinical outcomes after pharmacists' intervention.
  
  
  METHODS
  A prospective 1-year descriptive study was conducted from July 2010 to June 2011, at the adult HIV clinic of Jos University Teaching Hospital, Nigeria. DTPs and the associated pharmacist-initiated interventions were documented. Chi-square and Wilcoxon signed ranks test was used as appropriate, to compare the main outcome measures of pre- and post-intervention levels of viral load and CD+ cell count.
  
  
  RESULTS
  A total of 64,839 prescriptions were dispensed to 9320 patients. Interventions were documented for 85 unique patients (incidence of 1.31 interventions/1000 prescriptions), of which 62 (73%) and 3 (3.5%) were on first- and second-line ART, respectively, while 20 (23.5%) were yet to commence ART. Reasons for pharmacist intervention included failure to initiate therapy for HIV or hepatitis B infection; therapeutic failure (25.9%); and drug toxicity (24.7%). After intervention, the percentage of patients with HIV ribonucleic acid level <400 copies/mL rose from 29.4% to 67.1% (P < 0.001), while median (interquartile range) CD4+ cell count increased from 200 (123-351) to 361 (221-470) cells/mm(3) (P < 0.001).
  
  
  CONCLUSIONS
  Pharmacist intervention resulted in clinically significant improvements in patients HIV virological and immunological outcomes. This highlights an important role for the pharmacist in the treatment and care of HIV-infected patients, in a multidisciplinary team.
authors.affiliation: Department of Pharmacy, Jos University Teaching Hospital, Jos, Nigeria ; Department of Pharmacy, AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Jos, Nigeria.
authors.forename: Isaac O
authors.initials: IO
authors.lastname: Abah
authors.affiliation: Department of Pharmacy, Jos University Teaching Hospital, Jos, Nigeria ; Department of Pharmacy, AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Jos, Nigeria.
authors.forename: Victor B
authors.initials: VB
authors.lastname: Ojeh
authors.affiliation: Department of Pharmacy, AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Jos, Nigeria ; Department of Pharmacology, University of Jos, Jos, Nigeria.
authors.forename: Kakjing D
authors.initials: KD
authors.lastname: Falang
authors.affiliation: Division of Infectious Diseases, Center for Global Health, Northwestern University, Feinberg School of Medicine, Chicago, United States.
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Darin
authors.affiliation: AIDS Prevention Initiative in Nigeria Lte, Lagos, Nigeria.
authors.forename: Oluremi O
authors.initials: OO
authors.lastname: Olaitan
authors.affiliation: Department of Pharmacy, AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Jos, Nigeria ; Department of Medicine, Nephrology Unit, University of Jos, Jos, Nigeria.
authors.forename: Oche O
authors.initials: OO
authors.lastname: Agbaji
keywords: Antiretroviral therapy; drug therapy problem; pharmacist intervention