Adverse drug reactions to antiretroviral drugs and impact on treatment adherence among HIV patients in northwestern Nigeria
- 15 Downloads
Adverse drug reactions (ADRs) related to antiretroviral therapy (ART) have been a healthcare concern in the management of HIV. Information relating to ADR prevalence and its contribution to medication adherence is still limited in the northwestern part of Nigeria.
The aim of this study was to determine the prevalence of ADRs related to ART use, and its association with non-adherence to treatment.
A prospective observational study was conducted among HIV patients receiving ART at the ART unit of a specialist hospital in Jigawa State, the Northwestern region of Nigeria. Data were collected using patient interview and medical case folders. Patients were followed for 6 months for ADR monitoring. ADR causality was assessed using the WHO causality assessment.
Of the 167 patients in the study, 98 (58.7%) reported experiencing ADRs from ART use. Thirty-nine (44.8%) of the ADRs were possible, 16 (18.4%) were probable, 23 (26.4%) were unlikely, and 9 (10.3%) were conditional. Forty-one (47.1%) of the ADRs were mild, 45 (51.7%) were moderate, and 1 (1.2%) was severe. The most commonly reported ADRs were related to the CNS (163, 52%). ADRs led to non-adherence in 16 patients (16.3%) in the study (Chi-square = 12.1; p < 0.001).
The occurrence of ADRs associated with the use of ART is common and leads to non-adherence to ART among HIV patients. Adequate patient adherence counselling is therefore needed to improve adherence to ART, in addition to patient education and clinical interventions to manage ADRs.
The authors register their appreciation to all patients who participated in this study. The efforts of all staff of the ART clinic and Medical Records Department of the RSSH are also appreciated.
Compliance with ethical standards
This study was approved by the Ethical Committee of the RSSH.
Written informed consent was sought from all included patients prior to the commencement of the study. All data collection forms were de-identified to ensure confidentiality of the patient information.
No financial support was received for the conduct of this study.
Conflict of interest
Abubakar Musa Isa, Ibrahim Jatau Abubakar, and Basheer A. Z. Chedi have declared no conflicts of interest.
- 2.UNAIDS. UNAIDS Data 2017. http://www.unaids.org/sites/default/files/media_asset/20170720_Data_book_2017_en.pdf. Cited 8 July 2018.
- 8.Bhuvana K, Hema N. A prospective observational study of adverse drug reactions to antiretroviral therapy: type and risk factors in a tertiary care teaching hospital. Int J Basic Clin Pharmacol. 2014;3(2):380–4.Google Scholar
- 11.Bhuvana K, Hema N. A prospective observational study of adverse drug reactions to antiretroviral therapy: type and risk factors in a tertiary care teaching hospital. Int J Basic Clin Pharmacol. 2017;3(2):380–4.Google Scholar
- 12.Vaghani SV, et al. Adverse effects of antiretroviral treatment at a tertiary care hospital in India: a prospective observational study. Int J Res Med Sci. 2017;1(3):230–2.Google Scholar
- 15.The economic impact on non-adherence: microsimulation modelling for HIV/AIDS in New Zealand, NZAE Conference Paper; 2012.Google Scholar
- 16.World Health Organization. National Guideline for HIV and AIDS treatment and care in adolescents and adults. Abuja: Federal Ministry of Health; 2007.Google Scholar
- 17.Obiako O, et al. Adverse reactions associated with antiretroviral regimens in adult patients of a University Teaching Hospital HIV Program in Zaria, Northern Nigeria: an observational cohort study. J Antivirals Antiretrovirals. 2012;4:6–13.Google Scholar
- 18.Integrated National Guidelines for HIV prevention treatment and care. Nigeria: Federal Ministry of Health; 2014.Google Scholar
- 19.World Health Organization. Standardized Case Causality Assessment; 2011. http://www.who.int/medicines/areas/quality_safety/safety_efficacy/WHOcausality_assessment.pdf. Cited 7 Feb 2018.
- 20.Hartwig SC, Siegel J, Schneider PJ. Preventability and severity assessment in reporting adverse drug reactions. Am J Health Syst Pharm. 1992;49(9):2229–32.Google Scholar
- 22.World Health Organization. A Practical Handbook on the Pharmacovigilance of Medicines Used in the Treatment of Tuberculosis: Enhancing the Safety of the TB Patient; 2012. http://www.who.int/medicines/publications/Pharmaco_TB_web_v3.pdf. Cited 7 Feb 2018.
- 24.World Health Organization. WHO case definitions of HIV for surveillance and revised clinical staging and immunological classification of HIV-related disease in adults and children; 2007. http://www.who.int/hiv/pub/guidelines/arv2013/annexes/WHO_CG_annex_1.pdf. Cited 15 Feb 2018.
- 25.AIDSInfo. AIDSInfo Glossary of HIV/AIDS-Related Terms; 2018. https://aidsinfo.nih.gov/contentfiles/GlossaryHIVrelatedTerms_English.pdf. Cited 19 Feb 2018.
- 44.Jatau AI, Myat M, Kamauzaman TH, et al. Emergency department visit due to medication non-adherence at a teaching hospital in Malaysia. Int J Life Sci Rev. 2016;2:23–8.Google Scholar