title: Adverse drug reactions to antiretroviral therapy during the early art period at a tertiary hospital in Ghana.
abstract: BACKGROUND
  Antiretroviral therapy (ART) has reduced HIV morbidity and mortality worldwide but has many adverse effects. These adverse drug reactions (ADRs) lead to discontinuations, disease progression or treatment failure. We explored the types and risk factors for ADRs in a cohort starting ART in a teaching hospital in Accra, Ghana where the main regimens used were a combination of nucleotide and non nucleotide reverse transcriptase inhibitors.
  
  
  METHODS
  A Cross-sectional retrospective study was conducted reviewing data of 2042 patients initiated on HAART from 2003 to 2007. Univariate analysis was done for the dependent and independent variables. Stepwise logistic regression procedures were used to model the effect of gender on the development of ADRs controlling for other variables like age, marital status, weight at baseline and CD4 at baseline.
  
  
  RESULTS
  The period prevalence of ADRs was 9.4%. The two most common adverse reactions were anaemia and diarrhoea. Female sex was a statistically significant independent predictor of an adverse drug reaction (AOR: 1.66, p=0.01, CI: 1.16-2.36). CD4 counts 250 cells/mm3 or more was significantly associated with the occurrence of an ADR. The occurrence of anaemia in females was statistically significant compared to males.
  
  
  CONCLUSIONS
  Adverse drug reactions were less common than expected, anaemia was the commonest ADR. Female sex and high CD4 counts>250 mm3 were predictors of ADRs whereas females were significantly more likely to develop anaemia than males. Recommendations were made for interventions to prevent and also mitigate the high levels of anaemia especially among women in the ART scale up.
authors.affiliation: Department of Medicine and Therapeutics, University of Ghana Medical School, Accra, Ghana ; Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana.
authors.forename: Margaret
authors.initials: M
authors.lastname: Lartey
authors.affiliation: International Organization of Migration, Accra, Ghana.
authors.forename: Abena
authors.initials: A
authors.lastname: Asante-Quashie
authors.affiliation: Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana.
authors.forename: Ama
authors.initials: A
authors.lastname: Essel
authors.affiliation: Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana.
authors.forename: Ernest
authors.initials: E
authors.lastname: Kenu
authors.affiliation: Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana.
authors.forename: Vincent
authors.initials: V
authors.lastname: Ganu
authors.affiliation: Department of Medicine and Therapeutics, University of Ghana Medical School, Accra, Ghana ; Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana.
authors.forename: Alfred
authors.initials: A
authors.lastname: Neequaye
mesh_terms: D000328:Adult; D000740:Anemia / Q000139:chemically induced* / Q000453:epidemiology; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects / Q000379:methods; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D005869:Ghana / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D062606:Tertiary Care Centers; D013997:Time Factors
chemical_list: D019380:Anti-HIV Agents
keywords: Adverse Drug reaction; Anaemia; CD4 cells; Female sex; HAART; HIV