Maternal side effects of efavirenz-containing highly active antiretroviral therapy (HAART): A comparative study of HIV-positive pregnant and nonpregnant women in a tertiary hospital

Abstract

Background: Efavirenz is now a first-line non-nucleoside reverse transcriptase inhibitor used as highly active antiretroviral therapy (HAART) though its use is fraught with maternal side effects, usually of the central nervous system (CNS) and fetal complications. Objective: The study aims to comparatively document the maternal side-effect profile of an efavirenz-containing fixed-dosage HAART and compliance with its use in HIV-positive pregnant and nonpregnant women at the Lagos University Teaching Hospital (LUTH), Idi-Araba. Methodology: A prospective study among HIV-positive pregnant (40) and nonpregnant women (40) on efavirenz-containing fixed-dose HAART (Atripla®) who were recruited purposively at the antenatal clinic and AIDS Prevention Initiative Nigeria (APIN) clinics of LUTH. Data analysis was done with EPI Info 2014, and the results are presented in frequencies. Results: The mean age of respondents was 31 ± 5.7 years. Atripla® was the only fixed-dose combination used. Fifty-three percent and 62.5% of pregnant and nonpregnant HIV-positive women, respectively, reported CNS side effects of Atripla® [odds ratio: 0.66, 95% confidence interval 0.27–1.62]. Adherence to the use of Atripla® was 100% among HIV-positive pregnant women. Women with baseline viral load values greater than 400 copies/mL reported more side effects to Atripla®. Conclusion: There are similar side-effect profiles of Atripla® in HIV-positive women irrespective of pregnancy. Education and counselling can help foster adherence, resulting in improved immunological and virological outcome.