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Adverse Drug Reactions to Nonnucleoside Reverse Transcriptase Inhibitor-Based Antiretroviral Regimen: A 24-Week Prospective Study

Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Ravinder K. Sachdeva, PhD

Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Aman Sharma, MD

Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Ajay Wanchu, MD

Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India, awanchu@ yahoo.com

Background: Few studies have addressed the issue of adverse drug reactions with non-protease inhibitor (PI)-based antiretroviral therapy (ART) in resource-constrained settings. We studied prospectively the incidence of adverse drug reactions with generic ART among our patients.

Methodology: A total of 100 HIV-infected individuals were recruited. Patients received nevirapine (NVP) or efavirenz (EFV) with lamivudine (3TC) and zidovudine (ZDV)/stavudine (d4T). They were followed for 6 months for evidence of adverse drug reactions.

Results: The mean CD4 count was 114.09 ± 60.07 cells/mm³ (range, 12-232 cells/mm ³). Transient gastrointestinal symptoms were most frequent. Fourteen individuals (12 receiving ZDV/d4T, 3TC, NVP and 2 receiving ZDV/d4T, 3TC, EFV) developed skin rash. Among patients receiving NVP, 25.7% developed grade 1 hepatotoxicity. Three patients had numbness in both lower limbs. Among those individuals who received EFV, 32.3% individuals had central nervous system (CNS) symptoms in the form of insomnia, vivid dreams, dizziness, and drowsiness.

Conclusion: As the developing world increasingly uses generic ART, the clinician must be constantly vigilant for treatment-related adverse events.

Key Words: HIV • AIDS • adverse drug reaction • anti-retroviral therapy • nonnucleoside reverse transcriptase inhibitor

This version was published on September 1, 2009

Journal of the International Association of Physicians in AIDS Care (JIAPAC), Vol. 8, No. 5, 318-322 (2009)
DOI: 10.1177/1545109709343967


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