Adverse drug reactions to antiretroviral therapy during the early art period at a tertiary hospital in Ghana
Identifieur interne : 000501 ( Pmc/Curation ); précédent : 000500; suivant : 000502Adverse drug reactions to antiretroviral therapy during the early art period at a tertiary hospital in Ghana
Auteurs : Margaret Lartey [Ghana] ; Abena Asante-Quashie [Ghana] ; Ama Essel [Ghana] ; Ernest Kenu [Ghana] ; Vincent Ganu [Ghana] ; Alfred Neequaye [Ghana]Source :
- The Pan African Medical Journal [ 1937-8688 ] ; 2014.
Abstract
Antiretroviral therapy (ART) has reduced HIV morbidity and mortality worldwide but has many adverse effects. These adverse drug reactions (ADRs) lead to discontinuations, disease progression or treatment failure. We explored the types and risk factors for ADRs in a cohort starting ART in a teaching hospital in Accra, Ghana where the main regimens used were a combination of nucleotide and non nucleotide reverse transcriptase inhibitors.
A Cross-sectional retrospective study was conducted reviewing data of 2042 patients initiated on HAART from 2003 to 2007. Univariate analysis was done for the dependent and independent variables. Stepwise logistic regression procedures were used to model the effect of gender on the development of ADRs controlling for other variables like age, marital status, weight at baseline and CD4 at baseline.
The period prevalence of ADRs was 9.4%. The two most common adverse reactions were anaemia and diarrhoea. Female sex was a statistically significant independent predictor of an adverse drug reaction (AOR: 1.66, p = 0.01, CI: 1.16-2.36). CD4 counts 250 cells/mm3 or more was significantly associated with the occurrence of an ADR. The occurrence of anaemia in females was statistically significant compared to males.
Adverse drug reactions were less common than expected, anaemia was the commonest ADR. Female sex and high CD4 counts >250mm3 were predictors of ADRs whereas females were significantly more likely to develop anaemia than males. Recommendations were made for interventions to prevent and also mitigate the high levels of anaemia especially among women in the ART scale up.
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DOI: 10.11604/pamj.2014.18.25.3886
PubMed: 25368714
PubMed Central: 4214560
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uniqKey="Asante Quashie A" first="Abena" last="Asante-Quashie">Abena Asante-Quashie</name><affiliation wicri:level="1"><nlm:aff id="AF0003">International Organization of Migration, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>International Organization of Migration, Accra</wicri:regionArea></affiliation></author><author><name sortKey="Essel, Ama" sort="Essel, Ama" uniqKey="Essel A" first="Ama" last="Essel">Ama Essel</name><affiliation wicri:level="1"><nlm:aff id="AF0002">Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra</wicri:regionArea></affiliation></author><author><name sortKey="Kenu, Ernest" sort="Kenu, Ernest" uniqKey="Kenu E" first="Ernest" last="Kenu">Ernest Kenu</name><affiliation wicri:level="1"><nlm:aff id="AF0002">Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra</wicri:regionArea></affiliation></author><author><name sortKey="Ganu, Vincent" sort="Ganu, Vincent" uniqKey="Ganu V" first="Vincent" last="Ganu">Vincent Ganu</name><affiliation wicri:level="1"><nlm:aff id="AF0002">Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra</wicri:regionArea></affiliation></author><author><name sortKey="Neequaye, Alfred" sort="Neequaye, Alfred" uniqKey="Neequaye A" first="Alfred" last="Neequaye">Alfred Neequaye</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Department of Medicine and Therapeutics, University of Ghana Medical School, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Medicine and Therapeutics, University of Ghana Medical School, 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type="main">Adverse drug reactions to antiretroviral therapy during the early art period at a tertiary hospital in Ghana</title><author><name sortKey="Lartey, Margaret" sort="Lartey, Margaret" uniqKey="Lartey M" first="Margaret" last="Lartey">Margaret Lartey</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Department of Medicine and Therapeutics, University of Ghana Medical School, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Medicine and Therapeutics, University of Ghana Medical School, Accra</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="AF0002">Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra</wicri:regionArea></affiliation></author><author><name sortKey="Asante Quashie, Abena" sort="Asante Quashie, Abena" uniqKey="Asante Quashie A" first="Abena" last="Asante-Quashie">Abena Asante-Quashie</name><affiliation wicri:level="1"><nlm:aff id="AF0003">International Organization of Migration, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>International Organization of Migration, Accra</wicri:regionArea></affiliation></author><author><name sortKey="Essel, Ama" sort="Essel, Ama" uniqKey="Essel A" first="Ama" last="Essel">Ama Essel</name><affiliation wicri:level="1"><nlm:aff id="AF0002">Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra</wicri:regionArea></affiliation></author><author><name sortKey="Kenu, Ernest" sort="Kenu, Ernest" uniqKey="Kenu E" first="Ernest" last="Kenu">Ernest Kenu</name><affiliation wicri:level="1"><nlm:aff id="AF0002">Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra</wicri:regionArea></affiliation></author><author><name sortKey="Ganu, Vincent" sort="Ganu, Vincent" uniqKey="Ganu V" first="Vincent" last="Ganu">Vincent Ganu</name><affiliation wicri:level="1"><nlm:aff id="AF0002">Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra</wicri:regionArea></affiliation></author><author><name sortKey="Neequaye, Alfred" sort="Neequaye, Alfred" uniqKey="Neequaye A" first="Alfred" last="Neequaye">Alfred Neequaye</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Department of Medicine and Therapeutics, University of Ghana Medical School, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Medicine and Therapeutics, University of Ghana Medical School, Accra</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="AF0002">Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra</wicri:regionArea></affiliation></author></analytic><series><title level="j">The Pan African Medical Journal</title><idno type="eISSN">1937-8688</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>Introduction</title><p>Antiretroviral therapy (ART) has reduced HIV morbidity and mortality worldwide but has many adverse effects. These adverse drug reactions (ADRs) lead to discontinuations, disease progression or treatment failure. We explored the types and risk factors for ADRs in a cohort starting ART in a teaching hospital in Accra, Ghana where the main regimens used were a combination of nucleotide and non nucleotide reverse transcriptase inhibitors.</p></sec><sec id="st2"><title>Methods</title><p>A Cross-sectional retrospective study was conducted reviewing data of 2042 patients initiated on HAART from 2003 to 2007. Univariate analysis was done for the dependent and independent variables. Stepwise logistic regression procedures were used to model the effect of gender on the development of ADRs controlling for other variables like age, marital status, weight at baseline and CD4 at baseline.</p></sec><sec id="st3"><title>Results</title><p>The period prevalence of ADRs was 9.4%. The two most common adverse reactions were anaemia and diarrhoea. Female sex was a statistically significant independent predictor of an adverse drug reaction (AOR: 1.66, p = 0.01, CI: 1.16-2.36). CD4 counts 250 cells/mm3 or more was significantly associated with the occurrence of an ADR. The occurrence of anaemia in females was statistically significant compared to males.</p></sec><sec id="st4"><title>Conclusion</title><p>Adverse drug reactions were less common than expected, anaemia was the commonest ADR. Female sex and high CD4 counts >250mm3 were predictors of ADRs whereas females were significantly more likely to develop anaemia than males. Recommendations were made for interventions to prevent and also mitigate the high levels of anaemia especially among women in the ART scale up.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Bonnet, F" uniqKey="Bonnet F">F Bonnet</name></author><author><name sortKey="Morlat, P" uniqKey="Morlat P">P Morlat</name></author><author><name sortKey="Chene, G" uniqKey="Chene G">G Chêne</name></author><author><name sortKey="Mercie, P" uniqKey="Mercie P">P Mercié</name></author><author><name sortKey="Neau, D" uniqKey="Neau D">D Neau</name></author><author><name sortKey="Chossat, I" uniqKey="Chossat I">I Chossat</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Palella, Fj" uniqKey="Palella F">FJ Palella</name></author><author><name sortKey="Baker, Rk" uniqKey="Baker R">RK Baker</name></author><author><name sortKey="Moorman, Ac" uniqKey="Moorman A">AC Moorman</name></author><author><name 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Pan Afr Med J</journal-id><journal-id journal-id-type="iso-abbrev">Pan Afr Med J</journal-id><journal-id journal-id-type="publisher-id">PAMJ</journal-id><journal-title-group><journal-title>The Pan African Medical Journal</journal-title></journal-title-group><issn pub-type="epub">1937-8688</issn><publisher><publisher-name>The African Field Epidemiology Network</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25368714</article-id><article-id pub-id-type="pmc">4214560</article-id><article-id pub-id-type="publisher-id">PAMJ-18-25</article-id><article-id pub-id-type="doi">10.11604/pamj.2014.18.25.3886</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research</subject></subj-group></article-categories><title-group><article-title>Adverse drug reactions to antiretroviral therapy during the early art period at a tertiary hospital in Ghana</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Lartey</surname><given-names>Margaret</given-names></name><xref ref-type="aff" rid="AF0001">1</xref><xref ref-type="aff" rid="AF0002">2</xref><xref ref-type="corresp" rid="cor1">&</xref></contrib><contrib contrib-type="author"><name><surname>Asante-Quashie</surname><given-names>Abena</given-names></name><xref ref-type="aff" rid="AF0003">3</xref></contrib><contrib contrib-type="author"><name><surname>Essel</surname><given-names>Ama</given-names></name><xref ref-type="aff" rid="AF0002">2</xref></contrib><contrib contrib-type="author"><name><surname>Kenu</surname><given-names>Ernest</given-names></name><xref ref-type="aff" rid="AF0002">2</xref></contrib><contrib contrib-type="author"><name><surname>Ganu</surname><given-names>Vincent</given-names></name><xref ref-type="aff" rid="AF0002">2</xref></contrib><contrib contrib-type="author"><name><surname>Neequaye</surname><given-names>Alfred</given-names></name><xref ref-type="aff" rid="AF0001">1</xref><xref ref-type="aff" rid="AF0002">2</xref></contrib></contrib-group><aff id="AF0001"><label>1</label>Department of Medicine and Therapeutics, University of Ghana Medical School, Accra, Ghana</aff><aff id="AF0002"><label>2</label>Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana</aff><aff id="AF0003"><label>3</label>International Organization of Migration, Accra, Ghana</aff><author-notes><corresp id="cor1"><label>&</label>Corresponding author: Margaret Lartey, University of Ghana Medical School, Accra, Ghana, Fevers Unit, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana</corresp></author-notes><pub-date pub-type="epub"><day>07</day><month>5</month><year>2014</year></pub-date><pub-date pub-type="collection"><year>2014</year></pub-date><volume>18</volume><elocation-id>25</elocation-id><history><date date-type="received"><day>18</day><month>1</month><year>2014</year></date><date date-type="accepted"><day>28</day><month>4</month><year>2014</year></date></history><permissions><copyright-statement>© Margaret Lartey et al.</copyright-statement><copyright-year>2014</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0/"><license-p>The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><sec id="st1"><title>Introduction</title><p>Antiretroviral therapy (ART) has reduced HIV morbidity and mortality worldwide but has many adverse effects. These adverse drug reactions (ADRs) lead to discontinuations, disease progression or treatment failure. We explored the types and risk factors for ADRs in a cohort starting ART in a teaching hospital in Accra, Ghana where the main regimens used were a combination of nucleotide and non nucleotide reverse transcriptase inhibitors.</p></sec><sec id="st2"><title>Methods</title><p>A Cross-sectional retrospective study was conducted reviewing data of 2042 patients initiated on HAART from 2003 to 2007. Univariate analysis was done for the dependent and independent variables. Stepwise logistic regression procedures were used to model the effect of gender on the development of ADRs controlling for other variables like age, marital status, weight at baseline and CD4 at baseline.</p></sec><sec id="st3"><title>Results</title><p>The period prevalence of ADRs was 9.4%. The two most common adverse reactions were anaemia and diarrhoea. Female sex was a statistically significant independent predictor of an adverse drug reaction (AOR: 1.66, p = 0.01, CI: 1.16-2.36). CD4 counts 250 cells/mm3 or more was significantly associated with the occurrence of an ADR. The occurrence of anaemia in females was statistically significant compared to males.</p></sec><sec id="st4"><title>Conclusion</title><p>Adverse drug reactions were less common than expected, anaemia was the commonest ADR. Female sex and high CD4 counts >250mm3 were predictors of ADRs whereas females were significantly more likely to develop anaemia than males. Recommendations were made for interventions to prevent and also mitigate the high levels of anaemia especially among women in the ART scale up.</p></sec></abstract><kwd-group><kwd>Adverse Drug reaction</kwd><kwd>HAART</kwd><kwd>HIV</kwd><kwd>Female sex</kwd><kwd>Anaemia</kwd><kwd>CD4 cells</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Curation/RBID.i -Sk "pubmed:25368714" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Curation/biblio.hfd \
| NlmPubMed2Wicri -a SidaGhanaV1
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