Estimation of the Rationality of ARV Therapy in South India
The main objective of the present study was to perform and improve the rationality by looking for potential Drug-Drug Interactions and Adverse Drug Reactions associated with Anti-Retroviral Therapy and increase the adherence among Human Immunodeficiency Virus (HIV) patients attending to the Anti-Retroviral Therapy (ART) centre in south India. A prospective observational study was conducted in the city of Vijayawada, South India to assess the Adverse Drug Reactions (ADR’s) and Drug-Drug interactions (DDI’s) among the patients receiving Highly Active Anti RetroviralAnti- Retroviral Therapy (HAART) using approved scales and databases. A total of 530 patients were screened in a span of 1 year, resulting in 394 ADR’s and 385 DDI’s among the various drugs being used.The most commonly used drug combination was Tenofivir + Lamivudine + Efavirenz (63.3%). In looking at the reported ADR’s the majority of them were mild in terms of severity, preventability and causality and none of the DDI’s were severe enough to bring a change in the therapy. Statistical analysis was performed using SPSS 16 version by using Chi-square test. The risk caused by the associated ADR’s and DDI’s are observed and proven to be not deleterious in most of the cases. If adequate knowledge, prompt treatment and in-depth analysis of the associated risk factors and personal history were considered the HAART would be definitely more successful.
Keywords
- Mocroft A,Vella S, Benfield TL, Chiesi A, Miller V, Gargalianos Pet al. Changing patterns of mortality across Europe in patients infected with HIV-1 EuroSIDA Study Group. Lancet. 1998; 352(9142): 1725-30. https://doi.org/10.1016/S0140-6736(98)032 01-2
- UNAIDS. Report on the global HIV/AIDS epidemic 2008: Joint United Nations Programme on HIV/AIDS. Available on https://www.unaids.org/ en/resources/fact-sheet
- Ledergerber BM, et al. Clinical progression and virological failure on highly active antiretroviral therapy in HIV-1 patients: a prospective cohort study - Swiss HIV Cohort Study. Lancet. 1999; 353(9156): 86 3-8. https://doi.org/10.1016/S0140-6736(99)01122-8
- Edwards IR and JK Aronson. Adverse drug reactions: definitions, diagnosis, and management. Lancet. 2000; 356(9237):1255-9. https://doi.org/10.1016/S0140-673 6(00)02799-9
- Domingo P and F Lozano. Management of anti retroviral drug toxicity. EnfermedadesInfecciosasy MicrobiologiaClinica. 2011; 29(7):535-44. https:// doi.org/10.1016/j.eimc.2010.12.001
- WHO/Forum for collaborative HIV Research Joint Meeting, ARV drugs adverse events, case definition, grading, laboratory diagnosis and treatment monitoring, February 28-29, 2008. Geneva, Switzerland.
- Available on http://www.hivforum.org/index.php?option =com_content&task=view&id=59&Itemid=102
- Simone MJ, Appelbaum J. HIV in older adults. Geriatrics. 2008; 63(12): 6-12.
- Barry M, Mulcahy F, Merry C, Gibbons S, Back D. Pharmacokinetics and potential interactions amongst antiretroviral agents used to treat patient with HIV infection. Clin Pharmacokinet. 1999; 36(4):289304. https://doi.org/10.2165/00003088-199936040-00 004
- Furler MD, Einarson TR, Walmsley S, Millson M, Bendayan R. Polypharmacy in HIV: impact of data source and gender on reported drug utilization. AIDS Patient Care STDS 2004; 18(10): 568-586.
- https://doi.org/10.1089/apc.2004.18.568
- Park-Wyllie LY, Levine MA, Holbrook A,Thabane L, Antoniou T, Yoong D, et al. Outcomes of dosage adjustments used to manage antiretroviral drug interactions. Clin Infect Dis. 2007; 45(1): 933-936.
- https://doi.org/10.1086/521252
- Shah S, McGowan J, Opulski B, Lieblein A, Saperstein A. Identification of drug interactions involving antiretroviral therapy (ART) in New York City HIV specialty clinics. 14th Conference on Retroviruses and Opportunistic Infections. 25–28 February 2007, Los Angeles, CA, USA.
- de Maat MMR, de Boer A, Koks CH, Mulder JW, Meenhorst PL, van Gorp EC,et al. Evaluation of clinical pharmacist interventions on drug interactions in outpatient pharmaceutical HIV-care. J Clin Pharm Ther. 2004; 29(2): 121-130. https://doi.org/10.1111/j.13 65-2710.2003.00541.x
- Miller CD, El-Kholi R, Faragon JJ, Lodise TP. Prevalence and risk factors for clinically significant drug interactions with antiretroviral therapy. Pharmacotherapy 2007; 27(10): 1379-1386. https://doi.org/10.1592/phco.27.10.1379
- Naranjo CA, Busto U, Sellars EM, Sandor P, Ruiz I, Roberts EA and Janecek E. Method for
- Estimating the Probability of Adverse Drug Reactions. Clin Pharmacol Ther. 1981; 30(2): 239-45.
- https://doi.org/10.1038/clpt.1981.154
- Hartwig SC, Siegel J, Schneider PJ. Preventability and severity assessment in reporting adverse drug reactions. Am J Hosp Pharm. 1992; 49(9): 2229–32. https://doi.org/10.1093/ajhp/49.9.2229
- Schumock GT, Thornton JP. Focusing on the preventability of adverse drug reactions. Hosp Pharm. 1992; 27(6): 538.
- Malavika BP, Kumar RTS, Lakshmi BVS. Pharmacoepidemiology of antiretroviral drugs in a tertiary care teaching hospital. J Glob Phar Tech. 2020; 12(07): 01-07.
- Liverpool HIV drug interactions. Available on http:// www.hiv-druginteractions.org
- Modayil RR, A Harugeri, G Parthasarathi, M Ramesh, R Prasad, V Naik, et t.,al. Adverse drug reactions to antiretroviral therapy (ART): an experience of spontaneous reporting and intensive monitoring from ART centre in India. Pharmacoepidemiology and drug safety. 2010; 19(3): 247-55. https://doi.org/10.1002/pds.1907
- Hawkins C, C Achenbach, W Fryda, D Ngare, and R Murphy. Antiretroviral durability and tolerability in HIV-infected adults living in urban Kenya. J. Acquir. Immune Defic. Syndr. 2007; 45(3): 304-10.
- https://doi.org/10.1097/QAI.0b013e318050d66c
- National AIDS Control Organization Ministry of Health and Family Welfare Government of India.
- National technical guidelines on retroviralantiretroviral treatment. 2018.
- Bandyopadhyay A, Chaurasia RC, Palepu S, Yadav RK. A study of adherence to antiretroviral therapy in a tertiary care hospital at Allahabad, India. Indian J Sex Transm Dis AIDS. 2019; 40(1): 46–50. https:// doi.org/10.4103/ijstd.IJSTD_81_17
- Oreagba LA, Usman SO, Olayemi SO, Oshikoya KA, Opanuga O, Adeyemo TA, et.,al.
- Pharmacoepidemiology of antiretroviral drugs in a teaching hospital in Lagos, Nigeria. Ghana Med J.
- ; 48(4): 194-203. https://doi.org/10.4314/gmj.v4 8i4.5
- Meade CS, Sikkema KJ. HIV risk behaviour among adults with severe mental illness: a systematic review. Clin Psychol Rev 2005; 25(4): 433–457. https:// doi.org/10.1016/j.cpr.2005.02.001
- The Data Collection on Adverse Events of Anti-HIV Drugs (DAD) Study Group. Combination
- antiretroviral therapy and the risk of myocardial infarction. N Engl J Med 2003; 349: 1993–2003. https://doi.org/10.1056/NEJMoa030218
- d’ArminioMonforte A, Cozzi-Lepri A, Castagno A,Antinori A, De Luca A, Mussini C,et al. Risk of developing specific AIDS defining illnesses in patients co-infected with HIV and hepatitis C virus with or without liver cirrhosis. Clin Infect Dis 2009; 49(4): 612–622. https://doi.org/10.1086/603557
- Mohsen AH, Murad S, Easterbrook PJ. Prevalence of hepatitis C in an ethnically diverse HIV-1-infected cohort in south London. HIV Med 2005; 6(3):206– 215. https://doi.org/10.1111/j.1468-1293.2005.00291 .x
- Pham PA. Drug–drug interaction programs in clinical practice. Clin Pharmacol Ther 2008; 83(3): 396–398. https://doi.org/10.1038/sj.clpt.6100504
- Dooley KE, Flexner C, Andrade AS. Drug interactions involving combination antiretroviral therapy and other anti-infective agents: repercussions for resource-limited countries. J Infect Dis 2008; 198(7): 948–961.https://doi.org/10.1086/591459
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