Incidence and Causes and Factors for Changing ART regimens at Sena hospital

Abstract

The retrospective study was conducted to define the incidence , causes and the different factors of changing antiretroviral regimens for HIV-infected patients. The medical records of HIV-infected patients who received antiretroviral drugs at Sena hospital, Pranakornsriayutthaya province during 1 October 2004 and 30 September 2007 was recruited to find out the patients characteristics, epidermiological data, antiretroviral regimens and relevant clinical data. Total 72 cases were analyzed, the study showed that 36.11% had changed the initial antiretroviral regimens. Important causes of changing antiretroviral regimens included life-threatening adverse effects such as Stevens Johnsons syndrome or toxic epidermal necrolysis was detected 34.6% of the changed group, serious adverse effects such as skin rash 19.2% and hepatotoxicity 26.9% and long-term complication of lipodystrophy 7.7%. The others causes were antiretroviral treatment failure 7.7% and tuberculosis 3.8%. No statistical significant factors between the patients with changed and unchanged regimen were detected. However the long term study and follow up of CD4 count, CD4 lymphocytes percentage, HBsAg positive, Anti-HCV positive, high AST and ALT enzymes should be done for more delicated care of HIV-infected patients.