Table 4 showed the frequently reported adverse events to the ARV drugs with cough (13.3%), fever (8.75%), and skin rashes (8.01%) being the most frequently reported adverse events. Very few reports were made on several other adverse events including known and common adverse events to ARV drugs such as peripheral neuropathy (1.78%), nausea and vomiting (2.57%), anaemia and lipoatrophy (0.4%). Discussion This study highlighted the major ARV

drug combinations prescribed at APIN Clinic, LUTH, in Nigeria and the adverse events associated with their use. These adverse events are well characterized and known to be associated with the combinations given. The most frequently Thiazovivin prescribed combinations were AZT-3TC-NVP and D4T-3TC-NVP. These combinations and others prescribed are consistent with the guidelines of the WHO.30 The combinations are also in keeping with ABT-199 the

recommendations of the National guidelines for the use of ARV drugs in Nigeria.32 However the use of 23 different ARV drug combinations in a single clinic did not reflect rational prescribing and was in contrast to the National treatment guidelines.32 A closer look at these combinations revealed that less than 10% of them were due to treatment switches resulting from treatment failure or drug related toxicities. This irrational prescribing would suggest a need for training and re-training of the doctors on rational pharmacotherapeutics

of ARV drugs. The combination of AZT-3TC-EFV regimen, though recommended by the national guidelines, was less frequently prescribed probably because of intolerance to EFV and its contraindication in pregnancy.35 Majority of the patients were females, in their reproductive ages, and are likely to get pregnant during their course of treatment. This may be the reason why an EFV-based ART was avoided in the patients. The preponderance of female patients (in their 17-DMAG (Alvespimycin) HCl reproductive ages) afflicted with HIV in this study is in agreement with the United Nations report that over half of the 33.3 million people estimated to be living with HIV and AIDS at the end of year 2009 were women.36 Also, in Nigeria, HIV gender statistics in 2009 revealed that for age above 15 years, the prevalence was higher in women (52%) than in men (37%) and children (11%).37 Given that most often, the patients were literate, it will be appropriate to incorporate sex education and enlightenment campaign against HIV, directed more towards the female gender by the Federal Ministry of Health, into HIV/AIDS preventive measures in Nigeria. Medication adherence is a sine qua non for good therapeutic outcome in the management of HIV/AIDS infection with antiretroviral drugs.