Adverse Effects of Highly Active Antiretroviral Therapy in Developing Countries

Recent increases in access to highly active antiretroviral therapy (HAART) have made the management of drug toxicities an increasingly crucial component of human immunodeficiency virus (HIV) care in developing countries. The spectrum of adverse effects related to HAART in developing countries may di...

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Bibliographic Details
Published in:	Clinical infectious diseases 2007-10, Vol.45 (8), p.1093-1101
Main Authors:	Subbaraman, Ramnath, Chaguturu, Sreekanth Krishna, Mayer, Kenneth H., Flanigan, Timothy P., Kumarasamy, Nagalingeswaran
Format:	Article
Language:	eng
Subjects:	AIDS Anemia Antibiotics. Antiinfectious agents. Antiparasitic agents Antiretroviral drugs Antiretroviral Therapy, Highly Active - adverse effects Antiretrovirals Antiviral agents Biological and medical sciences Developing Countries Exanthema Hepatotoxicity Highly active antiretroviral therapy HIV HIV Infections - drug therapy HIV/AIDS Human immunodeficiency virus Human viral diseases Humans Immunodeficiencies Immunodeficiencies. Immunoglobulinopathies Immunopathology Infectious diseases LDCs Lipodystrophy Medical sciences Pharmacology. Drug treatments Predisposing factors Toxicity Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids
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Summary:	Recent increases in access to highly active antiretroviral therapy (HAART) have made the management of drug toxicities an increasingly crucial component of human immunodeficiency virus (HIV) care in developing countries. The spectrum of adverse effects related to HAART in developing countries may differ from that in developed countries because of the high prevalence of conditions such as anemia, malnutrition, and tuberculosis and frequent initial presentation with advanced HIV disease. The severity of adverse effects may vary as a result of host genetics and diagnostic delays attributable to inadequate laboratory monitoring. This article reviews current knowledge about toxicities related to HAART in resource-limited regions, which are in the process of rapid treatment scale-up. We conclude that initiating HAART before advanced immunosuppression, titrating doses in single-pill drug combinations to differences in patients' body weights, providing more intensive laboratory monitoring during the initial months of therapy, and providing access to less-toxic nucleoside reverse-transcriptase inhibitors may decrease the incidence of toxicities related to HAART in resource-limited regions.
ISSN:	1058-4838 1537-6591