Certain HIV drug side effects are more pronounced in African Americans and women, Temple University School of Medicine researchers reported in one of the first clinical trials of HIV drug therapy to include significant numbers of racial and ethnic minorities and women.

According to lead author Ellen Tedaldi, M.D., the most surprising finding was the high number of adverse psychiatric affects in African American men, which was 2.45 times higher than in men of other races.

Additionally, there were more cardiovascular and kidney side effects, 2.64 and 3.83 times more, respectively, among all African Americans, and 2.34 times more anemia in women.

Side effects were examined over five years in a group of 1,301 patients, including 701 African Americans, 225 Latinos and 273 women, who were starting drug therapy for HIV.

“The populations impacted most by HIV in the U.S. are African American and Latino, groups known to have healthcare disparities overall; for example, higher rates of hypertension, cardiovascular and kidney disease,” said Tedaldi, professor of medicine and director of the Comprehensive HIV Program at Temple.

“When you add HIV, with its impact on immune function, and socioeconomic and environmental conditions like poverty, poor nutrition and stress, you can see how it all contributes to worse health outcomes and a predisposition to some of these disparities.”

When physicians understand HIV drug therapy risks and effects, they can choose the best course of treatment for diverse populations. For example, psychiatric problems can have significant effects over the long term on adherence to HIV drug therapy as well as on medical outcomes.

The findings from the study are published in the April 2008 issue of the Journal of Acquired Immune Deficiency Syndrome.

“Overall, this study recognizes the vulnerabilities of particular populations with HIV,” Tedaldi said. “We need to try to get HIV patients identified sooner to minimize these adverse events and to work on the other health disparate conditions to prevent the long term complications of cardiovascular and renal disease.”


Other authors of “Ethnicity, Race, and Gender Differences in Serious Adverse Events Among Participants in an Antiretroviral Initiation Trial: Results of CPCRA 058 (FIRST Study)” include Mary van den Berg-Wolf, M.D., Temple Comprehensive HIV Program, Temple University School of Medicine; Judith Absalon, M.D., M.P.H., Harlem AIDS Treatment Group, Harlem Hospital Center, Mailman School of Public Health and Columbia University; Avis J. Thomas, M.S., Community Programs for Clinical Research on AIDS, Statistical and Data Management Center, University of Minnesota; and

Judith C. Shlay, M.D., M.S.P.H., Denver Community Programs for Clinical Research on AIDS, University of Colorado Health Sciences Center.

The National Institute of Allergy and Infectious Diseases at the National Institutes of

Health provided financial support for this study.