Original Research

Incidence of neuropsychiatric side effects of efavirenz in HIV-positive treatment-naïve patients in public-sector clinics in the Eastern Cape

Razia Gaida, Ilse Truter, Christoffel Grobler
Southern African Journal of HIV Medicine | Vol 17, No 1 | a452 | DOI: https://doi.org/10.4102/sajhivmed.v17i1.452 | © 2016 Razia Gaida, Ilse Truter, Christoffel Grobler | This work is licensed under CC Attribution 4.0
Submitted: 17 November 2015 | Published: 30 June 2016

About the author(s)

Razia Gaida, Department of Pharmacy, Nelson Mandela Metropolitan University, South Africa
Ilse Truter, Department of Pharmacy, Nelson Mandela Metropolitan University, South Africa; Drug Utilisation Research Unit, Nelson Mandela Metropolitan University, South Africa
Christoffel Grobler, Department of Pharmacy, Nelson Mandela Metropolitan University, South Africa


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Abstract

Background: It is acknowledged that almost half of patients initiated on efavirenz will experience at least one neuropsychiatric side effect.

Objectives: The aim was to determine the incidence and severity of neuropsychiatric side effects associated with efavirenz use in five public-sector primary healthcare clinics in the Eastern Cape.

Method: The study was a prospective drug utilisation study. A total of 126 medical records were reviewed to obtain the required information. After baseline assessment, follow-up reviews were conducted at 4 weeks, 12 weeks and 24 weeks from 2014 to 2015.

Results: The participant group was 74.60% female (n = 94), and the average age was 37.57±10.60 years. There were no neuropsychiatric side effects recorded for any patient. After the full follow-up period, there were a total of 49 non-adherent patients and one patient had demised. A non-adherent patient was defined as a patient who did not return to the clinic for follow-up assessment and medication refills 30 days or more after the appointed date. Some patients (n = 11) had sent a third party to the clinic to collect their antiretroviral therapy (ART). The clinic pharmacy would at times dispense a two-month supply of medication resulting in the patient presenting only every two months.

Conclusion: Further pharmacovigilance studies need to be conducted to determine the true incidence of these side effects. Healthcare staff must be encouraged to keep complete records to ensure meaningful patient assessments. Patients being initiated on ART need to personally attend the clinic monthly for at least the first 6 months of treatment. Clinic staff should receive regular training concerning ART, including changes made to guidelines as well as reminders of side effects experienced.

Keywords: neuropsychiatric; side effects; efavirenz; HIV-positive patients


Keywords

neuropsychiatric; side effects; efavirenz; HIV-positive patients

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Crossref Citations

1. Perspectives of healthcare professionals of the neuropsychiatric side effects associated with efavirenz and its management
Razia Gaida, Ilse Truter, Christoffel Grobler
Health SA Gesondheid  vol: 23  year: 2018  
doi: 10.4102/hsag.v23i0.1076