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KMID : 0984720030350020071
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Infection and Chemotherapy
2003 Volume.35 No. 2 p.71 ~ p.77
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Adverse Effects of Antiretroviral Drugs on HIV-infected Koreans
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Lee Kkot-Sil
Chang Kyung-Hee
Choi Jun-Yong
Park Yoon-Sun
Han Sang-Hoon
Chin Bum-Sik
Choi Suk Hoon
Song Young-Goo
Kim June-Myung
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Abstract
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Purpose: Antiretroviral toxicity is an increasingly important issue in the management of HIV-infected individuals. However, adverse effects and long term safety in Koreans are hardly known. We evaluated the incidence of a dverse effects of various antiretroviral drugs in Koreans, and difference among races was also studied.
Methods: One hundred and twenty six Koreans with HIV infection and AIDS treated with antiretroviral drugs at Yonsei University College of Medicine from 1992 to 2002 were investigated. We analyzed the prevalence of adverse effects of various drugs.
Results: The mean age of subjects at initial treatment was 34.4±8.3 years. One hundred and twelve subjects were male, and 14 subjects were female. Adverse effects were found in 40 subjects (33.3%) out of 120 subjects who received zidovudine. The prevalence of adverse effects of didanosine and indinavir were 48.3% (14 out of 29 subjects) and 57.9% (66 of 114 subjects), respectively. Frequent toxicities of the subjects who received zidovudine were bone marrow suppression (13.3%), followed by gastrointestinal intolerance (11.7%), headache (4.2%), and hepatic dysfunction (2.5%). Frequent toxicities of the subjects who received didanosine were gastrointestinal intolerance (24.1%), followed by diarrhea (13.8%), rash (3.4%), peripheral neuropathy (3.4%), and pancreatitis (3.4%). Adverse effects of indinavir were as follows: hyperbilirubinemia (37.7%), flank pain (21.1%), gastrointestinal intolerance (6.1%), and lipodystrophy (5.3%). The main adverse effect of efavirenz was impaired concentration (27.3%). The overall incidence of adverse effects from antiretroviral drugs was 64.3% (81 out of 126 subjects) in HIV-infected Koreans. Change of antiretroviral regimens was inevitable in 36 subjects (28.6%). In most cases, the subjects recovered from adverse effects by conservative management.
Conclusion: Clinicians should be aware of toxicity profiles in various races in the management of long term treatment with antiretroviral drugs, since the toxicity hazards of these drugs may easily outshadow the success of antiretroviral therapy.
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KEYWORD
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adverse effects, antiretroviral drugs, HIV, AIDS
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