Reasons for modification of initial antiretroviral therapy regimens among patients with HIV/AIDS in Adama Hospital Medical College, Adama, Ethiopia

Abstract

Highly active antiretroviral therapy (HAART) has markedly decreased the morbidity and mortality due to HIV/AIDS. A switch in the antiretroviral regimen is often necessary because of both acute and chronic toxicities, concomitant clinical conditions, and development of virological failure. The aim of this study was to assess the causes of initial HAART regimen changes among patients on ART in Adama Hospital Medical College (AHMC), Adama, Ethiopia. A retrospective cross-sectional study was done by reviewing patient information cards recorded from June 1, 2010 to June 1, 2014. Patients who changed their regimen were included in the study to identify the reasons for change. Data from patients below 18 years and those who did not switch HAART regimen were excluded. Out of 150 patients, 60% were females and 65.3% were in the age 18 to 32. Most of the patients (63.3%) were under the WHO clinical stage III patients and 35.3% of patients had a CD4 count in the range of 101-200 cells/mm³. The most common first regimen before first switch was D4T/3TC/NVP (32%), D4T/3TC/EFV (24.7%) and AZT/3TC/NVP (15.3%). The main reasons for modification of regimen were toxicity (70%), co-morbidity (12.7%), pregnancy (10%) and treatment failure (7.3%). The main types of toxicities observed were peripheral neuropathy (30.5%), lipoatrophy (18.1%) and anemia (17.1%). The result of this study indicated toxicity as the main reason for modification of initial ARV drugs among the study population.