Abstract

Workagegnehu Gezahegn*, Dinka Dugassa and Habte Gebeyehu

ABSTRACT

Background: Human Immune Virus (HIV) is responsible for a worldwide pandemic and it is the cause of Acquired Immune Deficiency Syndrome (AIDS). According to latest statistics 33.4 million individuals worldwide are living with HIV, of which 15.7 million (47%) are women and 2.1 million (6.3%) are children under 15 years. In addition there are 2.7 million new infections and 2.0 million deaths from AIDS worldwide. Objective: To determine the reason and contributing factors of antiretroviral regimen changes among patients on anti-retroviral therapy in ART clinic of Nedjo General Hospital. Method: A retrospective cross-sectional study was done using patient information sheet and physician diagnosis chart from January 1, 2008 to May, 2018. Result & Conclusion: Patients that changed their regimen were included in the study to identify the reasons for change and descriptive statistics were generated by calculating manually & using excels for figures. Out of 116 patients, 56% were females and 79.3% were in the age group 20-39. 47.4% were WHO clinical stage III patients and 50% of patients had missed their CD4 count. In 72.4% of patients initial treatment regimen was modified after six months, while, in 8.6% and 6 % of patient’s initial regimen was modified less than a month and within two to three month time respectively ,the most common initial regimens were D4T/3TC/NVP (50%), AZT/3TC/NVP (21.5%) and D4T/3TC/EFV (12.9%) The main reasons for modification of therapy were toxicity (53.4%), new drug (25%), treatment failure (9.5%), new TB (6.9%), stock out (1.7%), and pregnancy (0.9%) respectively. The main toxicity observed was peripheral neuropathy (51.6%) followed by rash (19.4%) and anemia (12.9%). Among toxicities observed 43.5% were due to D4T/3TC/NVP, and the remaining 24.2 %, 16.1 %, 8.1 %, 4.8 %, 1.6 % and 1.6 % were due to AZT/3TC/NVP, D4T/3TC/EFV, AZT/3TC/EFV, TDF/3TC/EFV, TDF/3TC/NVP, and TDF/3TC/LPVr respectively. D4T containing regimens accounted for 100% of the peripheral neuropathy observed, while NVP containing regimens accounted for 99.9% of the rashes reported and AZT containing regimens accounted for 100% of the Anemia observed. Toxicity was the main reason for initial regimen modification, D4T based regimens had high incidence of peripheral neuropathy.