HIV/AIDS drug regimens (both first, second and third line) used to treat adults, adolescent, children and pregnant women/ breast feeding mothers are made up of drug combinations such as TLD (Tenofovir, Lamivudine, and Dolutegravir, TLE (Tenofovir, Lamivudine, Efavirenz), ALD( Abacavir, Lamivudine, Dolutegravir), and drugs such as Zidovudine( AZT), Atazanavir ( ATV), Lopinavir(LPV), Emtricitabine (FTC), Darunavir (DRV), and Raltegravir (RAL).
These drugs are associated with different toxicities depending on drug composition which is explained as follows as per each drug
- Tenofovir (TDF) this has side effects like kidney failure liver injury and its contraindicated to people with underlying kidney disease and untreated Hypertension and diabetes
- Lamivudine (3TC) the side effects includes headache, nausea skin rashes and decrease in body weight and its contraindicated to those with underlying pancreas and kidney disease and breastfeeding mothers
- Dolutegravir (DTG) side effects includes Increase in body Cholesterol Kidney problems Headache and Insomnia while its contraindicated to those with Hypertension Diabetes
- Abacavir (ABC) it have side effects like allergic reactions Headache Diarrhea with loss of appetite and its contraindicated to those with Liver disease and breastfeeding mothers
- Zidovudine (AZT) the side effects includes anemia muscle pain and its contraindicated to people with liver injury anemia CD4 count < 200 cell/mm3
- Efavirenz (EFV) it have side effects such as difficulty in falling asleep nightmares, anxiety, and depression and its contraindicated to people with mentally illness and seizure disorders.
- Nevirapine (NVP) it may cause liver problems and its contraindicated to those with underlying liver disease and those with CD4 count >250 cells/mm3 and >400cells/mm3 in women and men respectively.
- Lopinavir (LPV) the side effect of this medicine involves severe diarrhea and can cause pancreatic diseases its contraindicated to those with underlying liver disease.
CHANGE OF REGIME OF ARTs
Previously the preferable regimen was TLE but its usage was stopped due to the side effects of efavirenz drug in its composition which involved nightmares, mental confusions, convulsions, depression and difficulty in falling asleep.
Currently in Tanzania the most preferred HIV/AIDS regimen is TLD but it is also associated with some side effects like kidney problems, nausea, diarrhea, difficulty in falling asleep and occasional dizziness. The regimen is contraindicated in cases of uncontrolled hypertension, uncontrolled diabetes mellitus, kidney impairment and liver diseases.
REPORTING OF HIV/AIDS DRUGS SIDE EFFECTS AND ADVERSE EFFECTS
The adverse effects of antiretroviral drugs can be grouped into two groups, the first one being those requiring prolonged hospitalization. These may cause disability or permanent damage and even congenital anomaly/ birth defects to Children. The other group include those requiring treatment interruption or a change in drug/regimen.
- Adverse drug reactions may be detected health care providers through interviewing patients, performing specific investigations or by screening patient records.
- Whenever patients suffer from any mentioned drug reactions, they should report to the available health care providers where they usually attend their routine clinics for ART therapy who consequently report to national level to ensure ADR monitoring.