Abstract:
Background: AIDS, which is acquired immune-deficiency syndrome, is treated by highly active
anti-retro viral therapy with cocktail of drugs including Nucleoside reverse transcriptase
inhibitors, Non-Nucleoside reverse transcriptase inhibitors and protease inhibitors. Anti-retro
viral therapy (ART) has markedly decreased the morbidity and mortality due to HIV disease.
However, toxicities, co morbidities, and treatment failure, among others would result in frequent
initial ART regimen change.
Objective: To determine the reasons for initial anti-retroviral regimen change among adult
patients on anti-retroviral therapy in Asella hospital ART clinic.
Methods: A retrospective cross-sectional study was conducted by using patient information
sheet record cards from Jan 01, 2013-Dec 31, 2013.
Result: One hundred fourty five patients switch their first regimen in Asella referral hospital
within the study period. The most frequent prescribed first regimens before switch were
AZT/3TC/NVP (36.55%), AZT/3TC/EFV (19.31%), D4T/3TC/NVP (13.79%), TDF/3TC/NVP
(13.1%, D4T/3TC/EFV (10.34%) and TDF/3TC/EFV (6.89%). Toxicity (70.34%) followed by
co-morbidity (16.55%), pregnancy (5.52%),Treatment failure (4.83%) and Drug stock out
(2.76%) were the most common reasons for modification of antiretroviral therapy.The main
toxicity was rash (51.96%) and peripheral neuropathy (28.48%).
Conclusion: The proportions of patients who modify HAART in our resource-constrained
setting present a challenge to the limited treatment options that currently present. Within these,
the main reasons for modifications in the study setting were toxicity, co morbidity and planning
pregnancy or pregnant were the top three.
Recommendation: The hospital should develop ADR data base so as to easily record and report
adverse effect of drugs.
