Adverse drug reactions associated with antiretroviral therapy in South Africa.
South Africa has one of the highest prevalences of HIV and AIDS in the world. HIV/AIDS patients face countless challenges, one of which is the risk of adverse drug reactions (ADRs). This study aimed to describe the ADRs reported in South Africa with reference to the type of ADRs, antiretrovirals (ARVs) implicated, seriousness of the ADRs and patient demographics associated with specific ADRs. A retrospective quantitative study was carried out using ADR reports submitted to the National Department of Health (NDoH) from 1 January 2010 to 31 December 2014. A descriptive and inferential analysis was carried out to determine the strength of the relationships between different variables. A total of 2 489 reports were analysed. This study found evidence of ADRs among patients on regimens based on stavudine (n = 1 256, 50.46%), efavirenz (n = 572, 22.98%), zidovudine (n = 209, 8.40%), tenofovir (n = 203, 8.16%) and nevirapine (n = 153, 6.15%). The 10 most common ADRs reported with the use of ARVs were peripheral neuropathy (n = 472, 19%), lipodystrophy (n = 471, 18.9%), serious skin reactions (n = 266, 10.7%), gynaecomastia (n = 219, 8.8%), renal failure (n = 140, 5.6%), dizziness (n = 133, 5.3%), hyperlactatemia (n = 118, 4.7%), psychosis/hallucinations (n = 47, 1.9%), sleep disturbances (n = 44, 1.8%) and vomiting (n = 44, 1.8%). Female patients were more likely to experience peripheral neuropathy, lipodystrophy, skin rash, anaemia and hyperlactatemia, while male patients were more prone to experience gynaecomastia and peripheral neuropathy. In addition, patients aged 30-44 years reported the most ADRs. Most reactions resulted from the use of stavudine, efavirenz, zidovudine, nevirapine and tenofovir in the population groups identified in this study.
a School of Health Sciences , University of KwaZulu-Natal , Westville Campus, Durban , South Africa.
Sumeshni
S
Birbal
a School of Health Sciences , University of KwaZulu-Natal , Westville Campus, Durban , South Africa.|b National Pharmacovigilance Centre, National Department of Health , South Africa.
Mukesh
M
Dheda
a School of Health Sciences , University of KwaZulu-Natal , Westville Campus, Durban , South Africa.
Elizabeth
E
Ojewole
a School of Health Sciences , University of KwaZulu-Natal , Westville Campus, Durban , South Africa.
Frasia
F
Oosthuizen
D000293:Adolescent; D000328:Adult; D000480:Alkynes; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects*; D048588:Benzoxazines / Q000008:administration & dosage / Q000009:adverse effects; D003521:Cyclopropanes; D004244:Dizziness / Q000139:chemically induced / Q000503:physiopathology; D005076:Exanthema / Q000139:chemically induced* / Q000503:physiopathology; D005260:Female; D006177:Gynecomastia / Q000139:chemically induced* / Q000473:pathology; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008060:Lipodystrophy / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D019829:Nevirapine / Q000008:administration & dosage / Q000009:adverse effects; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000503:physiopathology; D051437:Renal Insufficiency / Q000139:chemically induced* / Q000503:physiopathology; D012189:Retrospective Studies; D013019:South Africa; D018119:Stavudine / Q000008:administration & dosage / Q000009:adverse effects; D000068698:Tenofovir / Q000008:administration & dosage / Q000009:adverse effects; D015215:Zidovudine / Q000008:administration & dosage / Q000009:adverse effects
D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D015215:Zidovudine; D019829:Nevirapine; D000068698:Tenofovir; D018119:Stavudine; C098320:efavirenz
ADR reporting; drug safety; intervention; pharmacovigilance; seriousness