Switch over a antiretroviral (ARV) in AIDS cases.

Due to availability of cost effective ARV there is an increase in use of ARV which in turn leads to more chances of Adverse Drug Reactions (ADR) and treatment failure necessitating a switch to alternate regimen. The aim was to study number of cases requiring shift or switch causes and impact of the same. Ninety-five cases of ARV were thoroughly followed up and monitored for ADR and treatment failure. All cases were subjected to baseline investigations lipid profile were subjected to baseline investigations lipid profile and CD4 count which were repeated every 6 months and whenever required. In case showing treatment failure plasma viral load was carried out. Eighteen out on ninety-five cases (19%) were switched over to other regimen due to ADR treatment failure or default. ADR were noticed in 15 cases out of which nevirapine (NVP) was the commonest causative drug in 10 out of 15 cases followed by stavudine (d4T) in 3 out of 15 and zidovudine (AZT) in 2 out of 15 cases. Two cases were shifted over due to treatment failure. Alternate regimen was started in 1 case who had stopped treatment on his own. Regimen switch was required due to ADR mainly in cases on NVP or d4T. While switching over potential for drug resistance must be kept in mind. (authors)