Risk Factors of Nevirapine Hypersensitivity Reactions among Hiv-1 Infected Treatment Naïve Patients at Korle-Bu Teaching Hospital (Kbth) Accra

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.