Antiretroviral therapy-associated toxicities in the resource-poor world

The challenge of a limited formulary

Richard A. Murphy, Henry Sunpath, Daniel R. Kuritzkes, Francois Venter, Rajesh T. Gandhi

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Toxicities related to antiretroviral therapy make long-term adherence to therapy difficult for patients and present challenges to providers, especially those in the resource-poor world who work with a limited formulary. In resource-poor settings, where limited drug options are the rule, when and how to change therapy are especially difficult problems. Drugs such as stavudine and didanosine are associated with serious metabolic complications, such as lactic acidosis, pancreatitis, and peripheral neuropathy. Antiretroviral agents associated with fewer metabolic effects, such as tenofovir and abacavir, remain widely unavailable. Because the current formulary restrictions appear to be unlikely to change quickly, providers in resource-poor countries must be familiar with the common adverse events - including metabolic complications, hypersensitivity reactions, anemia, and liver enzyme abnormalities - and must understand how to manage them with what is locally available. Most importantly, to avoid drug toxicities, a larger formulary is needed in resource-poor settings, and this must be a high priority for policy makers and health care professionals involved in treating human immunodeficiency virus infection globally.

Original languageEnglish (US)
JournalJournal of Infectious Diseases
Volume196
Issue numberSUPPL. 3
DOIs
StatePublished - Dec 1 2007
Externally publishedYes

Fingerprint

Formularies
Tenofovir
Anti-Retroviral Agents
Stavudine
Didanosine
Lactic Acidosis
Peripheral Nervous System Diseases
Virus Diseases
Drug-Related Side Effects and Adverse Reactions
Administrative Personnel
Pharmaceutical Preparations
Pancreatitis
Anemia
Hypersensitivity
Therapeutics
HIV
Delivery of Health Care
Liver
Enzymes

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Immunology
  • Infectious Diseases
  • Immunology and Allergy

Cite this

Antiretroviral therapy-associated toxicities in the resource-poor world : The challenge of a limited formulary. / Murphy, Richard A.; Sunpath, Henry; Kuritzkes, Daniel R.; Venter, Francois; Gandhi, Rajesh T.

In: Journal of Infectious Diseases, Vol. 196, No. SUPPL. 3, 01.12.2007.

Research output: Contribution to journalArticle

Murphy, Richard A. ; Sunpath, Henry ; Kuritzkes, Daniel R. ; Venter, Francois ; Gandhi, Rajesh T. / Antiretroviral therapy-associated toxicities in the resource-poor world : The challenge of a limited formulary. In: Journal of Infectious Diseases. 2007 ; Vol. 196, No. SUPPL. 3.
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