Abstract

According to the data of the World Health Organization (WHO), human immunodeficiency virus (HIV) remains a major global public health problem.The mainmethod of treating HIV is using highly active antiretroviral therapy (HAART), which is the use of multiple medicines acting on different viral targets. The timely onset of HAART can suppress the replication of the virus in the human body and helps to strengthen its immune system and restore its ability to fight infections. At the same time, the choice of medicines to improve the quality of life and patients’ compliance during antiretroviral therapy should be based on their effectiveness and safety. The aim of this research was to analyze and study the adverse reactions that occur in patients with HIV living in the territory of the Republic of Crimea, when using HAART.Materials and methods.The objects of research were 274 report cards about the adverse reactions, registered in the regional base (registry) of spontaneous messages called ARCADe (Adverse Reactions in Crimea, Autonomic Database) for the period from 2011 to 2016.Results.The results of the study showed that the most often adverse reactions were observed when using medicines of the group of Nucleoside Reverse Transcriptase Inhibitors (NRTI). This is explained by the inclusion of NRTI medicines as the main medicine in the method of HAART. Efavirenz (EFV) and Nevirapine (NVP) were absolute leaders among these groups of antiretroviral medicines. Among the combined antiviral medicines active against HIV, the most frequently adverse reactions were associated with the use of a combination of Lamivudine (3TC) and Zidovudine (ZDV). The main clinical manifestations of adverse reactions in the use of combination medicines for treating HIV were a decrease in the level of hemoglobin and the development of anemia. At the same time, in 85% of cases, the patients needed medication in order to correct the resulting adverse drug reaction (ADR). The combination of antiretroviral therapy has often been associated with the development of serious ADR. In case of monotherapy, the main clinical manifestations of adverse reactions were disorders of the central nervous system (dizziness, hallucinations, sleep disorders) and allergic reactions of varying severity (including 1 case of angioedema to “Eferven” (Efavirenz (EFV)),600 mg). Hereby, in almost half of the cases, the usage of antiretroviral medicines of the NRTI group and protease inhibitors caused the development of serious side effects. This confirms the necessity to study and analyze adverse reactions in order to increase the safety of patients’ pharmacotherapy and improve their quality of life.Conclusion.The study of adverse reactions to the medicines used for treatment of HIV is of a paramount importance in improving the safety and compliance of HIV patients to lifelong pharmacotherapy.

Highlights

  • According to the World Health Organization (WHO) data, one of the first places in death statistics is taken by adverse reactions that occur during the use of medicines

  • For the analysis of adverse drug reaction (ADR) that occur when using drugs for treating human immunodeficiency virus (HIV), 274 report cards about ADR cases were selected; they were registered in the regional database of spontaneous messages ARCADe during the period from 2011 to 2016

  • The number of registered ADRs to antiretroviral medicines amounted to 5.4% of the total number of ADR report cards registered during this period (5047 cards)

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Summary

Introduction

According to the World Health Organization (WHO) data, one of the first places in death statistics is taken by adverse reactions that occur during the use of medicines. The study and evaluation of drug safety, the development of approaches to optimize the selection, prescription and rational use of drugs is the most important issue, especially for the diseases that hold leading positions in the prevalence, severity and mortality of the population. One of these diseases, the global nature of which has been confirmed by the WHO data, is the human immunodeficiency virus (HIV) [4]. The number of HIV-infected people registered in the Russian Federation at the end of 2015 amounted to more than 1 million people, with mortality rates of 212.500 people, which confirms the high social danger of this disease [6]

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