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Dr. M. Yugander Reddy, Araveti Lokesh*, Vatam Sivaranjani, S. Vijaya Lakshmi, M. Venkata Subbaiah


Zidovudine is the initial antiretroviral agent being used as Highly Active Antiretroviral Therapy (HAART) along with other drugs to decrease viral load in patients with HIV/AIDS. Its use is associated with hematological, dermatological, hepatic and musculoskeletal adverse effects which limits its use in most patients. Thus adequate evaluation and monitoring of patients on this drug therapy is essential for better care. Here the issue of 50 years female patient confirmed with HIV infection and under Zidovudine, Lamivudine and Nevirapine (ZLN) therapy since 5 years. And she was presented to general medicine department with the chief complaints of Fever, Breathlessness (BLN), and cough with sputum since 3 days. On physical examination she was found to have hyper-pigmentation on palms, nails and tongue, and her hematological parameters shown abnormalities in Hemoglobin (6 g/dl), WBC (3200 cells/mm3), platelets (1.0 lakhs/mm3). Through peripheral smear and blood cell count level we have confirmed microcytic, hypochromic anemia along with pancytopenia and later it was confirmed as drug (Zidovudine) induced through causality assessment. In the management of ADR ZLN regimen was replaced with TEL (Tenofovir Disoproxil Fumerate, Efavirenz and Lamivudine) and methylcobalamine and erythropoietin was administered. To prevent and/minimize drug induced complications and for better management we need to monitor the vitals and systems at risk at regular intervals during therapy.

Keywords: Zidovudine, Highly Active Antiretroviral Therapy, Causality assessment, Hyperpigmentation.

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