FACTORS INFLUENCING THE SUBSTITUTION OF ART IN HIV/AIDS PATIENTS ON FIRST LINE HIGHLY ACTIVE ANTIRETROVIRAL THERAPY

Authors

  • Sandeep B
  • Vasant r Chavan
  • Raghunandan M
  • Mohammad Arshad
  • Suresh Babu Sayana

Abstract

 

 Objectives: The aim was to determine the reasons for initial highly active antiretroviral therapy (HAART) regimen changes among human immunodeficiency virus/acquired immunodeficiency syndrome patients on HAART.

Methods: The present study is conducted retrospectively by reviewing the patient treatment records at antiretroviral therapy (ART) center RIMS Teaching Hospital, Raichur. Assessment and analysis were performed inpatient treatment records showing initial regimen changes and to identify the common reasons that resulted in these changes. The data were analyzed using SPSS version 16.0.

Results: A total of 3510 patient records were assessed, 520 cases (14.8%) among these had to change initial HAART regimens. The majority of the patients (53.7%) were males. The most common primary regimen, before the first substitution, was zidovudine/lamivudine/nevirapine (AZT/3TC/NVP) (33%), stavudine/3TC/NVP (25%), tenofovir/3TC/NVP (23%) and AZT/3TC/efavirenz (14%). Main reasons for the substitution to HAART regimens were comorbidity (58.26%), followed by adverse drug reactions (ADR) (38.46%).

Conclusion: Comorbidity was the main reason for the modification of initial HAART among the study population, followed by ADR in ART patients. Reports of comorbidity warrant further investigation, particularly because identifying these conditions are challenging in resource-limited settings.

Keywords: Highly active antiretroviral therapy, Initial regimen, Substitution, Comorbidity, Adverse drug reactions, Raichur.

References

Current Epidemiological Situation of HIV/AIDS. Department of AIDS Control, National AIDS Control Organization (NACO), Ministry of Health and Family Welfare, Government of India. Annual Report 2011-2012. Available from: http://www.aidsdatahub.org.

Operational Guidelines for Link ART Center and LAC Plus. National AIDS Control Organization (NACO), Ministry of Health and Family Welfare, Government of India; 2012. Available from: http://www.nacoonline.org.

Hammer SM. Increasing choices for HIV therapy. N Engl J Med 2002;346(26):2022-3.

Bangsberg DR. Less than 95% adherence to nonnucleoside reverse-transcriptase inhibitor therapy can lead to viral suppression. Clin Infect Dis 2006;43(7):939-41.

Nachega JB, Hislop M, Dowdy DW, Chaisson RE, Regensberg L, Maartens G. Adherence to nonnucleoside reverse transcriptase inhibitor-based HIV therapy and virologic outcomes. Ann Intern Med 2007;146(8):564-73.

Antiretroviral Therapy Guidelines for HIV-Infected Adults and Adolescents. Department of AIDS Control, National AIDS Control Organization (NACO), Ministry of Health and Family Welfare, Government of India; 2013. Available from: http://www.naco.gov.in.

Hart E, Curtis H, Wilkins E, Johnson M. National review of first treatment change after starting highly active antiretroviral therapy in antiretroviral-naïve patients. HIV Med 2007;8(3):186-91.

Eichetebaum. Pharmacokinetic interaction between ARVs and other drugs in HIV seropositives. AIDS 2002;41:577-96.

Timothy W, Marshall G, Roy M. HIV insight knowledge base chapter changing antiretroviral therapy: Why, when and how. J Acquir Immune Defic Syndr 2006;12:782-9.

Ammassari A, Murri R, Pezzotti P, Trotta MP, Ravasio L, De Longis P, et al. Self-reported symptoms and medication side effects influence adherence to highly active antiretroviral therapy in persons with HIV infection. J Acquir Immune Defic Syndr 2001;28(5):445-9.

Cesar C, Shepherd BE, Krolewiecki AJ, Fink VI, Schechter M, Tuboi SH, et al. Rates and reasons for early change of first HAART in HIV-1-infected patients in 7 sites throughout the Caribbean and Latin America. PLoS One 2010;5(6):e10490.

Messou E, Anglaret X, Duvignac J, Konan-N’dri E, Komena E, Gnokoro J, et al. Antiretroviral treatment changes in adults from Côte d’Ivoire: The roles of tuberculosis and pregnancy. AIDS 2010;24(1):93 9.

Kumarasamy N, Vallabhaneni S, Cecelia AJ, Yepthomi T, Balakrishnan P, Saghayam S, et al. Reasons for modification of generic highly active antiretroviral therapeutic regimens among patients in southern India. J Acquir Immune Defic Syndr 2006;41(1):53-8.

Kiguba R, Byakika-Tusiime J, Karamagi C, Ssali F, Mugyenyi P, Katabira E. Discontinuation and modification of highly active antiretroviral therapy in HIV-infected Ugandans: Prevalence and associated factors. J Acquir Immune Defic Syndr 2007;45(2):218-23.

d’Arminio Monforte A, Lepri AC, Rezza G, Pezzotti P, Antinori A, Phillips AN, et al. Insights into the reasons for discontinuation of the first highly active antiretroviral therapy (HAART) regimen in a cohort of antiretroviral naïve patients. I.CO.N.A. Study Group. Italian Cohort of Antiretroviral-Naïve Patients. AIDS 2000;14(5):499-507.

Dorrucci M, Pezzotti P, Grisorio B, Minardi C, Muro MS, Vullo V, et al. Time to discontinuation of the first highly active antiretroviral therapy regimen: A comparison between protease inhibitor- and non-nucleoside reverse transcriptase inhibitor-containing regimens. AIDS 2001;15(13):1733-6.

Mocroft A, Youle M, Moore A, Sabin CA, Madge S, Lepri AC, et al. Reasons for modification and discontinuation of antiretrovirals: Results from a single treatment centre. AIDS 2001;15(2):185-94.

O’Brien ME, Clark RA, Besch CL, Myers L, Kissinger P. Patterns and correlates of discontinuation of the initial HAART regimen in an urban outpatient cohort. J Acquir Immune Defic Syndr 2003;34(4):407-14.

Bangsberg DR, Acosta EP, Gupta R, Guzman D, Riley ED, Harrigan PR, et al. Adherence-resistance relationships for protease and non-nucleoside reverse transcriptase inhibitors explained by virological fitness. AIDS 2006;20(2):223-31.

Published

2014-11-01

How to Cite

B, S., V. r Chavan, R. M, M. Arshad, and S. B. Sayana. “FACTORS INFLUENCING THE SUBSTITUTION OF ART IN HIV/AIDS PATIENTS ON FIRST LINE HIGHLY ACTIVE ANTIRETROVIRAL THERAPY”. Asian Journal of Pharmaceutical and Clinical Research, vol. 7, no. 5, Nov. 2014, pp. 117-20, https://innovareacademics.in/journals/index.php/ajpcr/article/view/2641.

Issue

Section

Original Article(s)

Most read articles by the same author(s)