Understanding
and Avoiding
the Adverse
Events of HAART
Drug-related
adverse events
may become a
serious barrier
to the successful
use of HAART
in the treatment
of HIV infection.
Adverse events
from antiretroviral
use may significantly
impact morbidity
and mortality,
adversely affect
adherence
to therapy and
decrease the
quality
of life
for patients.
The
aim of the present
study, published
in Current
Pharmaceutical
Design (February
2006), is to
review prevention
and management
of adverse drug
reactions that
result from
antiretroviral
use in patients
infected with
HIV.
There
are currently
four classes
of antiretroviral
agents used
in the treatment
of HIV/AIDS.
Side
effects to medications
are common and
often difficult
to avoid. In
many cases,
research is
not able to
identify the
exact cause
of an event.
The
severity of
adverse reactions
varies greatly,
and some may
be difficult
to manage. Typically,
prevention is
more desirable
than treatment.
However, this
is not always
true. This article
reviews class-wide
and individual
side effects
from antiretrovirals
and, in some
cases, the mechanism
of action that
results in the
event.
Class-wide
side effects
for nucleoside/tide
reverse transcriptase
inhibitors (NRTIs)
include lactic
acidosis, peripheral
neuropathy
and lipoatrophy.
Adverse reactions
from individual
NRTIs, such
as abacavir-induced
hypersensitivity
reactions,
are also discussed.
Class-wide
side effects
to non-nucleoside
reverse transcriptase
inhibitors (NNRTIs)
include
rash and hepatotoxicity,
while efavirenz
(Sustiva)
has its own
unique CNS reactions.
Protease
inhibitor (PI)
side effects
include hyperglycemia,
lipoaccumulation,
dyslipidemia,
and
gastrointestinal
(GI) intolerance.
The
authors also
review specific
side effects
caused by indinavir
(Crixivan),
ritonavir
(Norvir),
and atazanavir
(Reyataz).
Finally, adverse
reactions from
the fusion inhibitor
enfuvirtide
(Fuzeon),
primarily injection
site reactions,
are addressed.
Although
antiretrovirals
have served
as an important
break-through
in the treatment
of HIV/AIDS,
conferring significant
survival benefits,
adverse reactions
from these drugs
can range from
mild to life-threatening,
and determining
which agent
is the cause
is frequently
difficult to
discern.
Fortunately,
drug-related
side effects
can be monitored,
treated and
in many cases,
prevented.
Western
University of
Health Sciences
College of Pharmacy,
Pomona, CA,USA.
03/14/06
Reference
S
Shibuyama. Understanding
and avoiding
antiretroviral
adverse events.
Current Pharmaceutical
Design 12(9):1075-1090.
2006.
