Highly active antiretroviral therapy: Incidence of adverse drug reactions

Abstract

The Acquired Immunodeficiency Syndrome (AIDS) was first recognized in 1981, in theUnitedStates of America in young homosexual men who had Kaposi sarcoma and serious infections. HIV is transmitted through unprotected sexual intercourse, transfusion ofcontaminated blood, sharing of contaminated needles and between a mother and her infant during pregnancy, childbirth and breastfeeding. In India, an estimated 0.1 percent of adults aged 15-49 are living with HIV, which seems low when compared to HIV prevalence in some parts of sub- Saharan Africa.The HIV prevalence at antenatal clinics was 1% in 2007. This number is smaller than the reported 1.26% in 2006, but remains the highest out of all states. HIV prevalence at STD clinics was very high at 17% in 2007.Although adverse reactions are common and often predictable, their management must be individualized.In addition, the patient's report of severity can be inconsistent with the clinical interpretation and this must be considered when determining the management of adverse reactions.Antiretroviral therapy is effective for HIV treatment but also increasingly complex. The many adverse effects of therapy may cause symptoms affecting a variety of organ systems. Patient nonadherence is the reason for the treatment failure to antiretroviral therapy. To optimize adherence treating physicians must focus on early detection and prevention of ADRs, when possible and distinguishing those that are self-limited from those that are potentially serious. Pharmacist should be able to detect ADRs and the culture of reporting ADRs should be instructed. All ART centers should have pharmacovigilance cell. All ADRs reported should be analyzed as per WHO guidelines of causal assessment.Our study concluded that there is a need of active Pharmacovigilance centre with intensive monitoring for ADRs by the Pharmacist in Indian HIV positive patients.