Antiretroviral Drug Exposures Reported to Texas Poison Centers

Abstract

Background. A number of different antiretroviral drugs are used to manage patients with human immunodeficiency virus (HIV). Objective. This study describes antiretroviral drug exposures reported to a large statewide poison center system. Methods. Cases were all antiretroviral drug exposures reported to the Texas Poison Center Network during 2000 to 2014. The distribution of cases was determined for various demographic and clinical factors. Results. Of a total of 632 exposures, the most commonly reported drugs were emtricitabine–tenofovir combination (17.1%), efavirenz–emtricitabine–tenofovir combination (13.8%), ritonavir (10.9%), lamivudine–zidovudine combination (10.3%), and efavirenz (10.1%). The annual number of antiretroviral drug exposures increased from 34 in 2000 to 67 in 2014. Males comprised 67.9% of the patients; 72.2% were 20 years or older. The exposures were 58.5% unintentional and 37.5% intentional. Only antiretroviral drugs were reported in 440 of the exposures. Of these exposures, 62.5% were managed on site, 28.0% were already at or en route to a health care facility when the poison center was contacted, and 8.6% were referred to a health care facility. The exposures were not serious in 88.7% of these cases. The most frequently reported adverse clinical effects were vomiting (5.7%), nausea (4.8%), dizziness/vertigo (3.2%), and drowsiness/lethargy (3.2%). Conclusions. The most commonly reported antiretroviral drugs were emtricitabine–tenofovir combination and efavirenz–emtricitabine–tenofovir combination. The patients were most likely to be adults and males. The exposures tended to be unintentional. Of those exposures involving only antiretroviral drugs, the majority of the exposures were not serious and could be managed outside of a health care facility.