Adverse events and adherence to HIV post-exposure prophylaxis: a cohort study at the Korle-Bu Teaching Hospital in Accra, Ghana.
Identifieur interne : 000270 ( PubMed/Checkpoint ); précédent : 000269; suivant : 000271Adverse events and adherence to HIV post-exposure prophylaxis: a cohort study at the Korle-Bu Teaching Hospital in Accra, Ghana.
Auteurs : Raymond A. Tetteh [Pays-Bas] ; Edmund T. Nartey [Ghana] ; Margaret Lartey [Ghana] ; Aukje K. Mantel-Teeuwisse [Pays-Bas] ; Hubert G M. Leufkens [Pays-Bas] ; Priscilla A. Nortey [Ghana] ; Alexander N O. Dodoo [Ghana]Source :
- BMC public health [ 1471-2458 ] ; 2015.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Agents antiVIH (administration et posologie), Association médicamenteuse, Exposition professionnelle (), Exposition professionnelle (effets indésirables), Femelle, Ghana (épidémiologie), Humains, Hôpitaux d'enseignement (organisation et administration), Infections à VIH (traitement médicamenteux), Infections à VIH (épidémiologie), Jeune adulte, Lamivudine (administration et posologie), Lamivudine (effets indésirables), Mâle, Prophylaxie après exposition (), Thérapie antirétrovirale hautement active (), Transmission de maladie infectieuse du patient au professionnel de santé (), Zidovudine (administration et posologie), Zidovudine (effets indésirables), Études de cohortes.
- MESH :
- administration et posologie : Agents antiVIH, Lamivudine, Zidovudine.
- effets indésirables : Exposition professionnelle, Lamivudine, Zidovudine.
- organisation et administration : Hôpitaux d'enseignement.
- traitement médicamenteux : Infections à VIH.
- épidémiologie : Ghana, Infections à VIH.
- Adulte, Adulte d'âge moyen, Association médicamenteuse, Exposition professionnelle, Femelle, Humains, Jeune adulte, Mâle, Prophylaxie après exposition, Thérapie antirétrovirale hautement active, Transmission de maladie infectieuse du patient au professionnel de santé, Études de cohortes.
- Wicri :
- geographic : Ghana.
English descriptors
- KwdEn :
- Adult, Anti-HIV Agents (administration & dosage), Antiretroviral Therapy, Highly Active (methods), Cohort Studies, Drug Combinations, Female, Ghana (epidemiology), HIV Infections (drug therapy), HIV Infections (epidemiology), Hospitals, Teaching (organization & administration), Humans, Infectious Disease Transmission, Patient-to-Professional (prevention & control), Lamivudine (administration & dosage), Lamivudine (adverse effects), Male, Middle Aged, Occupational Exposure (adverse effects), Occupational Exposure (prevention & control), Post-Exposure Prophylaxis (statistics & numerical data), Young Adult, Zidovudine (administration & dosage), Zidovudine (adverse effects).
- MESH :
- chemical , administration & dosage : Anti-HIV Agents, Lamivudine, Zidovudine.
- chemical , adverse effects : Lamivudine, Zidovudine.
- geographic , epidemiology : Ghana.
- adverse effects : Occupational Exposure.
- drug therapy : HIV Infections.
- epidemiology : HIV Infections.
- methods : Antiretroviral Therapy, Highly Active.
- organization & administration : Hospitals, Teaching.
- prevention & control : Infectious Disease Transmission, Patient-to-Professional, Occupational Exposure.
- statistics & numerical data : Post-Exposure Prophylaxis.
- Adult, Cohort Studies, Drug Combinations, Female, Humans, Male, Middle Aged, Young Adult.
Abstract
There is strong evidence that post-exposure prophylaxis (PEP) with antiretroviral drugs in the timely management of occupational exposures sustained by healthcare workers decreases the risk of HIV infection and PEP is now widely used. Antiretroviral drugs have well documented toxicities and produce adverse events in patients living with HIV/AIDS. In the era of "highly active antiretroviral therapy", non-adherence to treatment has been closely linked to the occurrence of adverse events in HIV patients and this ultimately influences treatment success but the influence of adverse events on adherence during PEP is less well studied.
DOI: 10.1186/s12889-015-1928-6
PubMed: 26092496
Affiliations:
- Ghana, Pays-Bas
- Région du Grand Accra, Utrecht (province)
- Accra, Legon (Ghana), Utrecht
- Université d'Utrecht, Université du Ghana
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pubmed:26092496Le document en format XML
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<front><div type="abstract" xml:lang="en">There is strong evidence that post-exposure prophylaxis (PEP) with antiretroviral drugs in the timely management of occupational exposures sustained by healthcare workers decreases the risk of HIV infection and PEP is now widely used. Antiretroviral drugs have well documented toxicities and produce adverse events in patients living with HIV/AIDS. In the era of "highly active antiretroviral therapy", non-adherence to treatment has been closely linked to the occurrence of adverse events in HIV patients and this ultimately influences treatment success but the influence of adverse events on adherence during PEP is less well studied.</div>
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<ELocationID EIdType="doi" ValidYN="Y">10.1186/s12889-015-1928-6</ELocationID>
<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">There is strong evidence that post-exposure prophylaxis (PEP) with antiretroviral drugs in the timely management of occupational exposures sustained by healthcare workers decreases the risk of HIV infection and PEP is now widely used. Antiretroviral drugs have well documented toxicities and produce adverse events in patients living with HIV/AIDS. In the era of "highly active antiretroviral therapy", non-adherence to treatment has been closely linked to the occurrence of adverse events in HIV patients and this ultimately influences treatment success but the influence of adverse events on adherence during PEP is less well studied.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">Following the introduction of a HIV post-exposure prophylaxis program in the Korle-Bu Teaching Hospital in January 2005, the incidence of adverse events and adherence were documented in occupationally-exposed healthcare workers (HCWs) and healthcare students (HCSs). Cohort event monitoring was used in following-up on exposed HCWs/HCSs for the two study outcomes; adverse events and adherence. All adverse events reported were grouped by MedDRA system organ classification and then by preferred term according to prophylaxis regimen. Adherence was determined by the completion of prophylaxis schedule. Cox proportional regression analysis was applied to determine the factors associated with the cohort study outcomes. Differences in frequencies were tested using the Chi square test and p < 0.05 was considered statistically significant.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">A total of 228 exposed HCWs/HCSs were followed up during the study, made up of 101 exposed HCWs/HCSs administered lamivudine/zidovudine (3TC/AZT) for 3 days; 75 exposed HCWs/HCSs administered lamivudine/zidovudine (3TC/AZT) for 28 days; and 52 exposed HCWs/HCSs administered lamivudine/zidovudine/lopinavir-ritonavir (3TC/AZT/LPV-RTV) for 28 days. The frequency of adverse events was 28% (n = 28) in exposed HCWs/HCSs administered 3TC/AZT for 3 days, 91% (n = 68) in exposed HCWs/HCSs administered 3TC/AZT for 28 days and 96% (n = 50) in exposed HCWs/HCSs administered 3TC/AZT/LPV-RTV for 28 days. Nausea was the most commonly reported adverse events in all three regimens. Adherence was complete in all exposed HCWs/HCSs administered 3TC/AZT for 3days, 56% (n = 42) in exposed HCWs/HCSs administered 3TC/AZT for 28 days and 62% (n = 32) in exposed HCWs/HCSs administered 3TC/AZT/LPV-RTV for 28 days. In the Cox regression multi-variate analysis, exposed HCWs/HCSs administered 3TC/AZT for 3 days were 70% less likely to report adverse events compared with exposed HCWs/HCSs administered 3TC/AZT for 28 days (Adjusted HR = 0.30 [95% CI, 0.18-0.48], p < 0.001). Exposed HCWs/HCSs administered 3TC/AZT for 3 days were 75% more likely to adhere to the schedule compared with exposed HCWs/HCSs administered 3TC/AZT for 28 days (Adjusted HR = 1.75 [95% CI, 1.16-2.66], p = 0.008).</AbstractText>
<AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The intolerance to adverse events was cited as the sole reason for truncating PEP, thereby indicating the need for adequate, appropriate and effective counselling, education, active follow-up (possibly through mobile /phone contact) and management of adverse events. Education on the need to complete PEP schedule (especially for exposed HCWs/HCSs on 28-day schedule) can lead to increased adherence, which is very critical in minimizing the risk of HIV sero-conversion. The present results also indicate that cohort event monitoring could be an effective pharmacovigilance tool in monitoring adverse events in exposed HCWs/HCSs on HIV post-exposure prophylaxis.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Tetteh</LastName>
<ForeName>Raymond A</ForeName>
<Initials>RA</Initials>
<AffiliationInfo><Affiliation>Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG, Utrecht, The Netherlands. r_niiatetteh@yahoo.com.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Pharmacy Department, Korle-Bu Teaching Hospital, P.O. Box KB 77, Korle-Bu, Accra, Ghana. r_niiatetteh@yahoo.com.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Nartey</LastName>
<ForeName>Edmund T</ForeName>
<Initials>ET</Initials>
<AffiliationInfo><Affiliation>World Health Organisation Collaborating Centre for Advocacy and Training in Pharmacovigilance, Centre for Tropical Clinical Pharmacology & Therapeutics, School of Medicine and Dentistry, University of Ghana, P. O. Box GP 4236, Accra, Ghana. etnartey@chs.edu.gh.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lartey</LastName>
<ForeName>Margaret</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Medicine, School of Medicine and Dentistry, University of Ghana, P. O. Box GP 4236, Accra, Ghana. malart38@yahoo.com.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Mantel-Teeuwisse</LastName>
<ForeName>Aukje K</ForeName>
<Initials>AK</Initials>
<AffiliationInfo><Affiliation>Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG, Utrecht, The Netherlands. A.K.Mantel@uu.nl.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Leufkens</LastName>
<ForeName>Hubert G M</ForeName>
<Initials>HG</Initials>
<AffiliationInfo><Affiliation>Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG, Utrecht, The Netherlands. H.G.M.Leufkens@uu.nl.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Medicines Evaluation Board, Utrecht, The Netherlands. H.G.M.Leufkens@uu.nl.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Nortey</LastName>
<ForeName>Priscilla A</ForeName>
<Initials>PA</Initials>
<AffiliationInfo><Affiliation>Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, P.O. Box LG 25, Legon, Accra, Ghana. prisnorts@yahoo.co.uk.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Dodoo</LastName>
<ForeName>Alexander N O</ForeName>
<Initials>AN</Initials>
<AffiliationInfo><Affiliation>World Health Organisation Collaborating Centre for Advocacy and Training in Pharmacovigilance, Centre for Tropical Clinical Pharmacology & Therapeutics, School of Medicine and Dentistry, University of Ghana, P. O. Box GP 4236, Accra, Ghana. alexooo@yahoo.com.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2015</Year>
<Month>06</Month>
<Day>20</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>England</Country>
<MedlineTA>BMC Public Health</MedlineTA>
<NlmUniqueID>100968562</NlmUniqueID>
<ISSNLinking>1471-2458</ISSNLinking>
</MedlineJournalInfo>
<ChemicalList><Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D019380">Anti-HIV Agents</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D004338">Drug Combinations</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="C109078">lamivudine, zidovudine drug combination</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>2T8Q726O95</RegistryNumber>
<NameOfSubstance UI="D019259">Lamivudine</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>4B9XT59T7S</RegistryNumber>
<NameOfSubstance UI="D015215">Zidovudine</NameOfSubstance>
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<CitationSubset>IM</CitationSubset>
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<MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D019380" MajorTopicYN="N">Anti-HIV Agents</DescriptorName>
<QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D023241" MajorTopicYN="N">Antiretroviral Therapy, Highly Active</DescriptorName>
<QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015331" MajorTopicYN="N">Cohort Studies</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D004338" MajorTopicYN="N">Drug Combinations</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005869" MajorTopicYN="N" Type="Geographic">Ghana</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015658" MajorTopicYN="N">HIV Infections</DescriptorName>
<QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006784" MajorTopicYN="N">Hospitals, Teaching</DescriptorName>
<QualifierName UI="Q000458" MajorTopicYN="N">organization & administration</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D017758" MajorTopicYN="N">Infectious Disease Transmission, Patient-to-Professional</DescriptorName>
<QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D019259" MajorTopicYN="N">Lamivudine</DescriptorName>
<QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName>
<QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016273" MajorTopicYN="N">Occupational Exposure</DescriptorName>
<QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName>
<QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D056990" MajorTopicYN="N">Post-Exposure Prophylaxis</DescriptorName>
<QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015215" MajorTopicYN="N">Zidovudine</DescriptorName>
<QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName>
<QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName>
</MeshHeading>
</MeshHeadingList>
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<ArticleIdList><ArticleId IdType="pubmed">26092496</ArticleId>
<ArticleId IdType="doi">10.1186/s12889-015-1928-6</ArticleId>
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<affiliations><list><country><li>Ghana</li>
<li>Pays-Bas</li>
</country>
<region><li>Région du Grand Accra</li>
<li>Utrecht (province)</li>
</region>
<settlement><li>Accra</li>
<li>Legon (Ghana)</li>
<li>Utrecht</li>
</settlement>
<orgName><li>Université d'Utrecht</li>
<li>Université du Ghana</li>
</orgName>
</list>
<tree><country name="Pays-Bas"><region name="Utrecht (province)"><name sortKey="Tetteh, Raymond A" sort="Tetteh, Raymond A" uniqKey="Tetteh R" first="Raymond A" last="Tetteh">Raymond A. Tetteh</name>
</region>
<name sortKey="Leufkens, Hubert G M" sort="Leufkens, Hubert G M" uniqKey="Leufkens H" first="Hubert G M" last="Leufkens">Hubert G M. Leufkens</name>
<name sortKey="Mantel Teeuwisse, Aukje K" sort="Mantel Teeuwisse, Aukje K" uniqKey="Mantel Teeuwisse A" first="Aukje K" last="Mantel-Teeuwisse">Aukje K. Mantel-Teeuwisse</name>
</country>
<country name="Ghana"><region name="Région du Grand Accra"><name sortKey="Nartey, Edmund T" sort="Nartey, Edmund T" uniqKey="Nartey E" first="Edmund T" last="Nartey">Edmund T. Nartey</name>
</region>
<name sortKey="Dodoo, Alexander N O" sort="Dodoo, Alexander N O" uniqKey="Dodoo A" first="Alexander N O" last="Dodoo">Alexander N O. Dodoo</name>
<name sortKey="Lartey, Margaret" sort="Lartey, Margaret" uniqKey="Lartey M" first="Margaret" last="Lartey">Margaret Lartey</name>
<name sortKey="Nortey, Priscilla A" sort="Nortey, Priscilla A" uniqKey="Nortey P" first="Priscilla A" last="Nortey">Priscilla A. Nortey</name>
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</tree>
</affiliations>
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