Collection and analysis of adverse drug reactions of antiretroviral therapy in a tertiary care hospital in central India

Background: The main objective of study is to monitor and analyze the adverse drug reactions (ADRs) of ART and to assess causality and severity of the ADRs detected.Methods: It is a prospective observational study conducted in the ART centre of a tertiary care teaching hospital in central India. The data collected were recorded on standard ADR reporting forms. Causality was assessed by Naranjo’s algorithm. Severity of ADR’s was assessed by modified Hartwig and Seigel scale. Modified Shumock and Thorton criteria used for preventability assessment.Results: In twelve months duration 351 patients on ART were observed for ADRs. Total 166 ADRs detected in 96 patients. Incidence of ADRs was slightly more in female. The common systems involved were gastrointestinal 42.77% followed by nervous system 18.07%, musculoskeletal 15.06% skin/mucous membrane 07.83%, metabolic and nutritional 04.82%, red blood cell disorders 01.20 %, endocrinal 00.60 % and others 09.64%. The causality assessment as per Naranjo’s scale showed that out of 166 ADRs, 28.92% were probable and 71.08% were possible. Severity assessment by modified Hartwig and Siegel scale showed that 83.34% ADRs were mild and 15.66% were moderate. 46.39 % ADRs were probably preventable.Conclusions: Considering the magnitude of ADR related problems, there is a need for greater awareness among health care professionals, to detect and report them. These ADRs if recognized in time and managed properly can prevent treatment interruption.

Late Onset Adverse Drug Reactions Of Stavudine In Comparison With Zidovudine; Reason For Discontinuation

The main objective of study is to compare the adverse drug reactions (ADRs) of Zidovudine and Stavudine containing regimens. It is a prospective observational study conducted in the ART centre of a tertiary care teaching hospital in central India. The data collected were recorded on standard ADR reporting forms. Standard scales were used for assessment of ADRs. In twelve months duration total 263 patients on ART were observed for ADRs. 128 patients on Stavudine based regimen and 135 patients were on Zidovudine based regimen. Total 72 ADRs detected in 68 patients. Incidence of ADRs was more in Zidovudine based regimen. Zidovudine associated with early and mild ADRs while Stavudine associated with late and distressing ADRs. Considering the magnitude of ADR related problems, results support the discontinuation of Stavudine based regimens