Abstract:
Dr. William Kudzi
Background: The face of HIV/AIDS disease is constantly evolving, spreading among
populations, and the virus mutating to become resistant to available antiretroviral
drugs. Nevirapine, a NNRTI is widely used as the first-line treatment of HIV-1
infection in developing countries. Although it is generally well tolerated and effective,
some individuals experience severe cutaneous and/or hepatic adverse events during
the initial weeks of therapy. The risk factors associated with the development of this
noxious and unintended response is inconsistent in different populations.
Identification of the pre-disposing factors would aid the prescription and
administration of ARV agents to the over 35 million people living with HIV. Adverse
drug reactions (ADRs) are increasingly recognized as one of the most common reason
for the discontinuation of treatment or switch in sub-Saharan Africa (Danq &
Bhandare, 2012). Findings from this study may improve therapeutic effect at the
individual level, within different population and maximize the antiviral effect in
reducing the risk of serious adverse events that characterized treatment
discontinuation, switch, non-adherence and hospitalization.
Aim: The aim of this study was to determine the risk factors associated with the
development of nevirapine-induced hypersensitivity reactions characterized by
cutaneous and hepatic adverse events in HIV-1 infected treatment-naïve patients at
the Korle-Bu Teaching Hospital.
Methodology: Seventy three HIV-1 infected treatment-naïve Ghanaian patients were
prospectively followed after nevirapine initiation at the Fevers Unit of Korle-Bu
Teaching Hospital. The study involved among others, a 24 week follow-up of
recruited subjects after ARV initiation, ALT and AST serum concentration
determination, and physical examination for possible cutaneous nevirapine-induced
rash. Blood samples were taken for DNA extractions that were used for PCR-RFLP
analysis and sequencing for genotyping. Logistic regression to find association was
employed to determine significant relationship.
Results: Out of the 73 recruited subjects, 15.7% developed NVP-induced HSR, but
the outcome had no correlation to the factors considered in this study.
Conclusion: The 15.7% observed outcome is a clear manifestation of the NVPinduced
HSR among HIV-1 infected Ghanaian population but none of the factors
considered this study was statistically significant.