Abstract
Background: Highly active antiretroviral therapy (HAART) program requires adequate monitoring of the potential adverse events to the antiretroviral (ARV) drugs. We investigated the ARV drug combinations prescribed for HIV- infected children and their suspected adverse events. Methods: This is a retrospective and descriptive study involving HIV- infected children less than 15 years old who received treatment at the APIN clinic, Lagos University Teaching Hospital (LUTH) in Nigeria. The case files of 80 patients initiated on HAART, between January 2008 and December 2009, were reviewed. Their demographics, clinical details and medication use, the prescribed HAART regimen, and the suspected clinical and laboratory adverse events were extracted. Results: The patients were female (46; 57.5%) preponderant with a median age of 3 (IQR: 1.1-6.0) years. Zidovudine- lamivudine- nevirapine (AZT-3TC-NVP) combination (74; 92.5%) was the most frequently prescribed first-line regimen. Thirty three patients changed their first-line HAART to abacavir-lamivudine-lopinavir boosted with ritonavir (ABC-3TC-LVP/r) (11; 33.3%), and zidovudine- lamivudine- abacavir- lopinavir boosted with ritonavir (AZT-3TC-ABC-LVP/r) (8; 24.2%) combinations. Of the 80 patients included in the study, 38(47.7%) experienced 142 adverse events. The most frequently experienced clinical adverse events were nevirapine-induced skin rashes (93; 65.5%), vomiting (19; 13.4%), and pallor (12; 8.5%). Macrocytosis (22/72; 30.6%), anaemia (6/72; 8.3%), and thrombocytopenia (2/72; 2.8%) were the commonest haematological adverse events associated with zidovudine. Conclusions: The HAART regimens used for HIV-infected children in this study have a good safety profile. Their few adverse events suggest a need for prospective pharmacovigilance to effectively monitor the toxicities of ARV drugs.
Highlights
The burden of HIV is high globally as it remains the greatest health crisis facing the world today
This strategy evolved from the recognition that continual treatment of HIV infection with only one or two ARV agents would typically result in rapid treatment failure and development of ARV resistance which may compromise future therapeutic options [4,5]
This retrospective descriptive study was conducted at the Lagos University Teaching Hospital (LUTH) in Nigeria and involved HIVinfected children who had been initiated on Highly active antiretroviral therapy (HAART) and were receiving treatment at the AIDS Prevention Initiative in Nigeria (APIN) clinic at LUTH, between January 2008 and December 2010
Summary
The burden of HIV is high globally as it remains the greatest health crisis facing the world today. Active antiretroviral therapy (HAART); defined as a combination of three or more antiretroviral (ARV) agents taken concurrently to suppress HIV replication, represents the current standard of care of antiretroviral therapy for children infected with HIV [4]. This strategy evolved from the recognition that continual treatment of HIV infection with only one or two ARV agents would typically result in rapid treatment failure and development of ARV resistance which may compromise future therapeutic options [4,5]. We investigated the ARV drug combinations prescribed for HIV- infected children and their suspected adverse events
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