Retrospective Study Of Regimen Change Among HIV/AIDS Patient Initiated On First Line Highly Active Anti Retroviral therapy In Asella Hospital Art Clinic, Asella, South East Ethiopia.

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.