Open AccessComparative incidence of adverse drug reaction during the first and subsequent year of antiretroviral therapy in a Nigerian HIV infected cohort
Author(s) -
Isaac Okoh Abah,
Wetkos D Dayom,
Dauda Audi Dangiwa,
Roseline Iberi Aderemi-Williams,
Joseph Anejo-Okopi,
Oche Agbaji,
Phyllis Kanki,
John Chinyere Aguiyi
Publication year - 2021
Publication title -
african health sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.391
H-Index - 44
eISSN - 1729-0503
pISSN - 1680-6905
DOI - 10.4314/ahs.v21i3.10
Subject(s) - medicine , incidence (geometry) , cohort , pediatrics , rate ratio , population , cohort study , confidence interval , antiretroviral therapy , human immunodeficiency virus (hiv) , viral load , immunology , physics , environmental health , optics
Background: Despite close to two decades of antiretroviral therapy (ART) in Nigeria, data on late on-onset ART-associated adverse drug reactions (ADRs) are sparse.
Objectives: To describe early and late-onset ADRs and compare their incidence in an outpatient HIV positive Cohort on ART.
Method: We described the incidence of clinical ADRs identified and documented in an outpatient clinic cohort of HIV-pos- itive patients treated between June 2004 and December 2015 at a tertiary health facility in Nigeria. Incidence rates of ADRs during the first and subsequent years of ART were compared.
Results: of the 13,983 patients’ data analyzed, 9317 were females (66%), and those in the age bracket of 25 to 45 years made up 78% of the studied population. During 52,411 person-years (py) of ART, 1485 incident ADRs were recorded; Incidence rate (IR) 28.3 (95% confidence interval [CI] 26.9:29.8) ADRs per 1000 person-years (py) of ART. The IR of ADRs was about two times higher in the first year of ART compared to subsequent years of treatment; crude incidence rate ratio (IRR) 1.77 (95% CI 1.59:1.97). Anemia, hypersensitivity reactions, and nervous system disorders had 7, 23, and 5 times higher incidence, respectively, in the first year of therapy, compared to subsequent years.
Conclusion: The first year of ART is the period of highest risk of ADRs. Individual and programmatic treatment success in resource-limited settings requires strategies for early identification and management of ADR during the period of greatest risk of ADRs.
Keywords: Adverse drug events; antiretroviral therapy; drug toxicity; sub- Saharan Africa.