Evaluating the impact of antiretroviral and antiseizure medication interactions on treatment effectiveness among outpatient clinic attendees with HIV in Zambia.

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dc.contributor.affiliationDepartment of Biostatistics, Center for AIDS Research, University of Rochester, Rochester, NY, USA.
dc.contributor.affiliationNational Institute of Neurological Disorders and Stroke, Bethesda, MD, USA.
dc.contributor.affiliationDepartment of Neurology, University of Rochester, Rochester, NY, USA.
dc.contributor.affiliationDepartment of Internal Medicine, Center for Vaccines and Virology Research, Beth Israel Deaconess Medical Center, Boston, MA, USA.
dc.contributor.affiliationUniversity Teaching Hospitals Children's Hospital, Lusaka, Zambia.
dc.contributor.affiliationInfectious Disease Service, Brooke Army Medical Center, Joint Base San Antonio-Ft Sam Houston, Houston, TX, USA.
dc.contributor.affiliationCenter for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia.
dc.contributor.affiliationGlobal Neurology Program, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
dc.contributor.affiliationDepartment of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia.
dc.contributor.affiliationGreater Lawrence Family Health Center, Lawrence, MA, USA.
dc.contributor.affiliationDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
dc.contributor.affiliationDepartments of Neurology, Pediatrics, Neuroscience and Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY, USA.
dc.contributor.affiliationDepartment of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
dc.contributor.affiliationChikankata Epilepsy Care Team, Mazabuka, Zambia.
dc.contributor.authorNavis A
dc.contributor.authorDallah I
dc.contributor.authorMabeta C
dc.contributor.authorMusukuma K
dc.contributor.authorSiddiqi OK
dc.contributor.authorBositis CM
dc.contributor.authorKoralnik IJ
dc.contributor.authorGelbard HA
dc.contributor.authorTheodore WH
dc.contributor.authorOkulicz JF
dc.contributor.authorJohnson BA
dc.contributor.authorSikazwe I
dc.contributor.authorBearden DR
dc.contributor.authorBirbeck GL
dc.date.accessioned2025-05-23T11:41:05Z
dc.date.issued2020-Dec
dc.description.abstractOBJECTIVE: Interactions between enzyme-inducing anti-seizure medications (EI-ASMs) and antiretroviral drugs (ARVs) can lead to decreased ARV levels and may increase the likelihood of viral resistance. We conducted a study to determine if co-usage of ARVs and EI-ASMs is associated with ARV-resistant human immunodeficiency virus (HIV) among people living with HIV in Zambia. METHODS: Eligible participants were ≥18 years of age and concurrently taking ASMs and ARVs for at least 1 month of the prior 6-month period. Data were obtained regarding medication and HIV history. CD4 counts, plasma viral loads (pVLs), and HIV genotype and resistance profile in participants with a pVL >1000 copies/mL were obtained. Pearson's test of independence was used to determine whether treatment with EI-ASM was associated with pVL >1000/mL copies. RESULTS: Of 50 participants, 41 (82%) were taking carbamazepine (37 on monotherapy), and all had stable regimens in the prior 6 months. Among the 13 ARV regimens used, 68% had a tenofovir/lamivudine backbone. The majority (94%) were on a stable ARV regimen for >6 months. Median CD4 nadir was 205 cells/mm SIGNIFICANCE: EI-ASMs are commonly used in sub-Saharan Africa. Despite concurrent use of EI-ASMs and ARVs, the majority of participants showed CD4 counts >200 cells/mm
dc.identifier.doi10.1111/epi.16723
dc.identifier.urihttps://pubs.cidrz.org/handle/123456789/10395
dc.sourceEpilepsia
dc.titleEvaluating the impact of antiretroviral and antiseizure medication interactions on treatment effectiveness among outpatient clinic attendees with HIV in Zambia.

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