Prevalence and predictors of adverse drug reactions to first line antiretroviral therapy among adolescents at ISS Clinic-Mbarara Regional Referral Hospital

Abstract

Background: HIV/AIDs remains a major threat to the health sector impacting negatively on the social and economic development of the community. With the advent of HAART there has been a reduction on AIDS related mortality. However the ADRs from these drugs are limiting the success of HAART.

Objective: To determine the prevalence and predictors of adverse drug reactions to first line HAART among adolescents at ISS clinic- MRRH

Methodology: A retrospective cross-sectional study was conducted at ISS clinic-MRRH among adolescent (10-19years) patients taking first line HAART. A total of 196 patient files were reviewed to obtain ADR related information. Data was entered into and analyzed using SPSS version 23. Predictors of ADRs were assessed by bivariate analysis and those found significant were further subjected to multivariate logistic regression model and were considered significant if P<0.05.

Results: Out of the 196 patients, 52% were female and the mean age was 14.7 SD ±2.455, average duration on HAART in years was 7.69 ±3.498. The clinical characteristics for most patients at HAART initiation were; CD4>500 (53.1%), VL>5000(64.3%), BMI<18.5(60.7%), WHO clinical stage 3 (53.1%). Most of the patients (56%) were on AZT/3TC/NVP and 8% were on TDF/3TC/EFV. ADRs were observed in 76.5% of the patients, with skin rash (34%) and CNS toxicities (29.6%) being the most prevalent. NVP and ABC based regimens had more incidences of skin rash 45% and 32.3% respectively. Predictors that were found to be significantly associated with ADRs were; BMI<18.5 AOR: 10.13, 95% C.I: 4.36-23.50; P=<0,001 and CD4>500 AOR: 0.254, 95% C.I: 0.18-0.593, P=0.02.

Conclusion: There is a high prevalence of ADRs among adolescents at ISS clinic –MRRH and the predictors of ADRs among the adolescents were BMI<18.5 and CD4>500.

Key terms: Prevalence, ADRs and adolescents.