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Apr 26, 2021
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Apr 26, 2021
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Abstract

Introduction


Adverse neurological events during antiretroviral treatment (ART) are frequent and various1-3. Their diagnosis is difficult in developing countries where human resources and infrastructures are most of the time lacking.


Aim


To identify the frequency of neurological side effects in patients under ART in Mali


Methods


We performed a prospective cohort study on patients developing neurological symptoms  in a period of 12 months at the Department of Infectious Diseases of the Teaching Hospital “Point G” of Bamako, Mali. Neurological diagnostic was established with the guidance of a neurologist. WHO’s sides effects table has been used to characterize and classify the side effects4. Analysis of data was performed with SPSS Software, version 12.0.


Results


A total of 420 HIV seropositive patients under ART have been followed.  Of those, 37 cases were found with adverse neurological events (8.08%). The sex ratio M/F was 1.06 and. the mean age was 41.2 years. Of the side effects, polyneuritis alone represented 83.8% of the cases, and polyneuritis associated to vertigo, headache and depression represented the remaining 16.2 %. We didn’t notice any these neurological symptoms at the initiation of the ART. The majority of the patients was infected by HIV-1 (91.9 %). Most of the patients, 89.2% were treated with a fixed dose combination of Triomune® (D4T+3TC +Nevirapine).  Five cases were at 3rd stage of WHO classification (13.5%), which justified stopping the treatment with d4T.


Conclusions


The use of Triomune® led to neurological adverse events in Mali. Any further new antiretroviral regimens must include a pharmacovigilance to detect eventual neurological side effects.

Keywords

Adverse neurological events Pharmacovigilance Antiretroviral therapy Mali

Article Details

How to Cite
Oumar AA, Maiga M, Dembele JP, Djibril N, Sangho F, Konate I, Kone Y, Guida L, Tulkens PM, & Dao S. (2021). Adverse neurological events due to antiretroviral therapy in Mali. International Journal of Research in Pharmacology & Pharmacotherapeutics, 4(4), 455-459. https://doi.org/10.61096/ijrpp.v4.iss4.2015.455-459
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References

  1. [1]. UNAIDS/WHO (2009).Report on the global AIDS epidemic. Geneva: unaids, 2009. www.unaids.org
  2. [2]. Samake S, Traore SM, Ba S,Dembele E, Diop M, Mariko S, Libite PR. Enquete Demographique de la santé, Mali IV. Decembre 2006. CPS/MS/DNSI/MEIC Bamako, Mali et Macro International Inc. Calverton, Maryland, USA. www.cspro.org/pubs/pdf/FR199/FR199.pdf
  3. [3]. Moulignier A, Moulonguet A. Manifestations neurologiques in Girard PM, Katlama C, Pialoux G, VIH 2007 Edition Doin pp 97-127.
  4. [4]. Luciano CA, Pardo CA, McArthur JC. Recents developments in the HIV neuropathies. Curr Opin Neurol 2003, 16:403-9.
  5. [5]. Mouhari-Touré, Saka B, Kombaté K, Tchangai-Walla K, Pitche P. Clinical safety of generic fixed-dose combination of stavudine/lamivudine/névirapine (Triomune). Study of 297 cases in Togo. Bull Soc Pathol Exot, 2008, 101(5):404-6.
  6. [6]. Moulignier A, Girard PM. Principaux traitements anti-VIH,Toxicité neurologique et interactions à éviter. Neurologie 2003,4 :140-4.
  7. [7]. Dao S, Oumar AA, Coulibaly D, Sylla A, Coulibaly B, Diallo A. Causes de décès des patients sous traitement antiretroviral dans le service de maladies infectieuses de l’hôpital du point G à Bamako, Mali. Louvain Med, 2009, 128, 1.
  8. [8]. Coulibaly SM., Oumar AA., Ag Aboubacrine S., et al. [The clinical and biological tolerance of nevirapine among patients with AIDS under treatment at the Hospital of the Point G]. Mali Med 2007, 22:1-4.
  9. [9]. WHO ARV drugs adverse events, case definition, grading, laboratory diagnosis and treatment monitoring. Geneva, WHO, 2008.
  10. [10]. Milligo A, Sawadogo AB, Sawadogo AP,Lankoandé D. [Peripheral neuropathies revealing HIV infection at the Hospital Center of Bobo-Dioulasso (Burkina Faso)] Bull Soc Pathol Exot, 95(1):27-30.
  11. [11]. Millogo A, Ki-Zerbo GA, Sawadogo AB, Ouedraogo I, Yameogo A, Tamini MM, Peghini M. [Neurologic manifestations associated with HIV infections at the Bobo-Dioulasso Hospital Center (Burkina Faso)]. Bull Soc Pathol Exot 1999, 92(1):23-6.
  12. [12]. Millogo A, Lankoandé D, Yaméogo I, Yaméogo AA, Sawadogo AB. Polyneuropathies in patients treated with HAART in Bobo-Dioulasso Hospital Burkina Faso. Bull Soc Pathol Exot2008, 101 (1):11-3.
  13. [13]. Millogo A, Mare D, Hema A, Sessouma B. Les polyneuropathies chez les patients infectés par le VIH à l’ère des antirétroviraux au CHU de Bobo-Dioulasso (Burkina Faso) African Journal of Neurological Sciences 2008, 27(1) :67-72.
  14. [14]. Chêne G, Angelini E, Cotte L, Lang JM, Morlat P, Rancinan C, May T, Journot V, Raffi F, Jarrousse B, Grappin M, Lepeu G, Molina JM.Role of long-tern nucleoside-analogue therapy in lipodystrophy and metabolic disorders in human immunodeficiency virus-infected patients. Clin Infect Dis 2002, 34(5):649-57.
  15. [15]. Dalakas MC. Peripheral neuropathy and antiretroviral drugs. J peripher Nerv Syst 2001, 6, 14-20.
  16. [16]. Ferrari S,Vento S, Monaco S, Cavallaro T, Cainelli F et al . Human immunodeficiency virus-associated peripheral neuropathies. Mayo Clin Proc2006,81,213-219
  17. [17]. Peltier AC, Russell JW. Advances in understanding drug-induced neuropathies. Drug Saf 2006, 29(1):23-30.
  18. [18]. Wulff EA, Wang AK, Simpson DM. HIV-associated peripheral neuropathy: epidemiology, pathophysiology and treatment. Drugs 2000,59(6):1251-60.
  19. [19]. Gastaut JL (2000). Neuropathies péripheriques, In :Mréjen S, Moulingnier A. Atteintes neurologiques et infection par le VIH. Ed Médecine-Flammarion Sciences, pp.138-143.
  20. [20]. Schifitto G, McDermott MP, McArthur JC, Marder K, Sacktor N, Epstein L, Kieburtz K. Incidence of and risk factors for HIV-associated distal sensory polyneuropathy. Neurology 2002, 58(12):1764-8.
  21. [21]. Moyle GJ, Sadler M. Peripheral neuropathy with nucleoside antiretrovirals: risk factors, incidence and management. Drug Saf 1998, 19(6):481-94.
  22. [22]. Moulonguet A. Peripheral Neuropathy in HIV-infected subjects. Rev Neurol 2003, 159(12):1223-6.
  23. [23]. Lichtenstein KA, Armon C, Baron, Moorman AC, Wood KC, Holmberg SD. Modification of the incidence of drug-associated symmetrical peripheral neuropathy by host and disease factors in the HIV outpatient study cohort. Clin Infect Dis 2005, 40(1):148-57.
  24. [24]. Simpson DM. Selected peripheral neuropathies associated with human immunodeficiency virus infection and antiretroviral therapy. J Neurovirol 2002, 8(Suppl 2)2:33-41.
  25. [25]. Verma A. Epidemiology and clinical features of HIV-1 associated neuropathies. J Peripher Nerv Syst 2001 6(1):8-13.
  26. [26]. Pettersen JA, Jones G, Worthington C, Krentz HB, Keppler OT, Hoke a, Gill MJ, Power C.Sensory neuropathy in human immunodeficiency virus/acquired immunodeficiency syndrome patients: protease inhibitor-mediated neurotoxicity. Ann Neurol 2006, 59(5):816-24.