An investigation into the traditional Health practitioners' HIV/AIDS knowledge, atitude/beliefs and practices in Lusaka and Chongwe Districts
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Date
2015-02-23
Authors
Mpande, Mutandwa Norman
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Abstract
Atazanavir-ritonavir (ATV-r) has been recommended by the World Health Organization as part of second-line combination antiretroviral therapy (cART) in HIV-infected patients
aged 6 years and above. In 2013, the Zambia HIV treatment program introduced ATV-ras an alternative Protease Inhibitor (PI) to lopinavir-ritonavir (LPV-r) because of its gastrointestinal tolerability, lipid profile and once-daily dosing. However, data about the
safety and tolerability of ATV-r-containing regimens in sub-Saharan Africa continues to be inadequate. A cross sectional study was undertaken which evaluated clinical and laboratory events
among HIV-infected adult patients initiating ATV-r-based second-line cART at the
University Teaching Hospital in Lusaka, Zambia between December 2013 and April
2014. A sample of 49 patients’ medical records were selected and reviewed.
SPSS version
16 was used for analysis. Association between demographic variables (age and gender)and the AEs was assessed using chi-square. Ethical approval was obtained from the University of Zambia Biomedical Research Ethics Committee.
Following initiation of ATV-r, the vast majority of the study patients did not report adverse events (n=40, 81.6%). Among those with adverse events, jaundice (n=2, 4.1%)and diarrhoea (n=4, 8.2%) were the predominant complaints. Overall, hyperbilirubinaemia
was the most common laboratory adverse event (n=3, 6.1%) and it was not associated with either age (p=0.755) or gender (p=0.604). The clinical adverse events reported by the patients also showed no association with the demographic characteristics. There were no
treatment discontinuations of the ATV-r regimen based on these events.
ATV-r-based regimen appeared to be safe in the study population. Hyperbilirubinaemia
was the most frequently observed laboratory AE though it did not prompt discontinuation
of this drug. Continued safety and tolerability monitoring of ATV-based regimens is needed in resource limited settings, particularly for longer observation periods. Direct
comparisons with other PI-based combinations are urgent, for the precise understanding of the efficacy and toxic effects.
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Keywords
HIV/AIDS-Zambia , HIV/AIDS-Awareness