An assessment of adverse drug reaction patterns among HIV positive patients receiving antiretroviral therapy in a tertiary care hospital

Rita Kumari, S. Chandra, M. Gari, A. Kumari
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引用次数: 9

Abstract

Background and Objectives: Antiretroviral therapy (ART) has been proved efficacious in reducing morbidity and mortality related to Human Immunodeficiency Virus (HIV) infection, however, also associated with long and short term drug induced toxicities. This study was conducted to monitor the adverse drug reactions (ADRs) associated with various antiretroviral drug regimens, its causality, severity and preventability assessment in patients receiving ART. Methods: Using a prospective observational study design, 280 patients were enrolled for the study. The ADR monitoring was carried out for a period of one year (December 2015 - November 2016) in patients living with HIV (PLHIV) and receiving ART from an outpatient setting of nodal ART centre of Rajendra Institute of Medical Sciences, Ranchi (Jharkhand). Results: A total of 280 patients were monitored by active surveillance. Out of them 228 patients identified of at least one or more ADRs. The most number of ADRs were observed with ZLN (Zidovudin + Lamivudin + Nevirapin) and ZLE (Zidovudin + Lamivudin + Efavirenz). The ADRs commonly found, GIT side effects (29%), CNS side effects (27%) and anaemia (25%). Tenofovir based regimens was safer than ZLN and ZLE. Conclusion: Type of antiretroviral regimen and time since initiation of ART were associated in causality of related adverse reactions. This study addressed the added morbidity among HIV patients taking ART. With the increasing incidence of ADRs associated with antiretroviral chemotherapy, it requires proper monitoring and reporting to intervene at an early stage and modify the antiretroviral drug regimen (ARV) as per.
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在三级保健医院接受抗逆转录病毒治疗的艾滋病毒阳性患者中药物不良反应模式的评估
背景和目的:抗逆转录病毒疗法(ART)已被证明在降低与人类免疫缺陷病毒(HIV)感染相关的发病率和死亡率方面有效,但也与长期和短期药物诱导的毒性有关。本研究旨在监测接受抗逆转录病毒治疗的患者与各种抗逆转录病毒药物方案相关的药物不良反应(adr)、其因果关系、严重程度和可预防性评估。方法:采用前瞻性观察性研究设计,纳入280例患者。在Ranchi (Jharkhand) Rajendra医学科学研究所节点抗逆转录病毒治疗中心门诊接受抗逆转录病毒治疗的艾滋病毒感染者(PLHIV)中进行了为期一年(2015年12月至2016年11月)的不良反应监测。结果:280例患者接受主动监测。其中228例患者至少有一种或多种不良反应。ZLN(齐多夫定+拉米夫定+奈韦拉平)和ZLE(齐多夫定+拉米夫定+依非韦伦)出现的不良反应最多。常见的不良反应是胃肠道副作用(29%)、中枢神经系统副作用(27%)和贫血(25%)。替诺福韦为基础的方案比ZLN和ZLE更安全。结论:抗逆转录病毒治疗方案的类型和开始抗逆转录病毒治疗的时间与相关不良反应的因果关系有关。本研究解决了接受抗逆转录病毒治疗的艾滋病毒患者发病率增加的问题。随着与抗逆转录病毒化疗相关的不良反应发生率的增加,需要适当的监测和报告,以便在早期进行干预,并根据需要修改抗逆转录病毒药物方案(ARV)。
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