A Pharmacovigilance Insights into Adverse Drug Reactions, Antiretroviral Therapy Adherence, and Quality of Life in HIV/AIDS
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Abstract
Antiretroviral therapy (ART) has significantly improved the clinical management of HIV/AIDS; however, its effectiveness may be influenced by adverse drug reactions (ADRs), treatment adherence, and patients’ quality of life (QoL). This study aimed to systematically examine the relationships among ADRs, ART adherence, and QoL among people living with HIV/AIDS within an integrated pharmacovigilance framework. A systematic literature review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Literature searches were performed using Google Scholar, Scopus, and ScienceDirect to identify peer-reviewed articles published between 2018 and 2026. Following the screening and eligibility assessment process, 21 articles were included in the qualitative synthesis. The findings indicate that ADRs are associated with lower ART adherence, with one study reporting that the absence of ADRs was associated with higher odds of treatment adherence (adjusted odds ratio [AOR] = 5.33; 95% confidence interval [CI]: 1.95–14.57). Treatment-related discomfort was also identified as a factor contributing to medication non-adherence. Furthermore, ADRs and symptom burden, including pain, fatigue, and neurological symptoms, were associated with poorer functioning and quality of life across physical and psychological domains. ART adherence was generally associated with better QoL, although several studies reported inconsistent or statistically nonsignificant relationships. These variations may reflect differences in patient characteristics, healthcare settings, measurement instruments, clinical conditions, and psychosocial factors, including family support and social stigma. Overall, the evidence suggests that ADRs, ART adherence, and QoL are interrelated dimensions of HIV/AIDS management, although the predominantly observational evidence does not establish causal relationships. Integrating standardized ADR monitoring, patient-centered adverse reaction reporting, adherence assessment, and QoL evaluation into routine HIV care may support more comprehensive and individualized treatment. Further prospective studies and well-controlled interventions are needed to clarify these relationships and evaluate the effectiveness of integrated pharmacovigilance strategies.
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