Background: Adverse drug reactions (ADRs) related to antiretroviral therapy (ART) have been a healthcare concern in the management of HIV. Information relating to ADR prevalence and its contribution to medication adherence is still limited in the northwestern part of Nigeria.

Objective: The aim of this study was to determine the prevalence of ADRs related to ART use, and its association with non-adherence to treatment.

Methods: A prospective observational study was conducted among HIV patients receiving ART at the ART unit of a specialist hospital in Jigawa State, the Northwestern region of Nigeria. Data were collected using patient interview and medical case folders. Patients were followed for 6 months for ADR monitoring. ADR causality was assessed using the WHO causality assessment.

Results: Of the 167 patients in the study, 98 (58.7%) reported experiencing ADRs from ART use. Thirty-nine (44.8%) of the ADRs were possible, 16 (18.4%) were probable, 23 (26.4%) were unlikely, and 9 (10.3%) were conditional. Forty-one (47.1%) of the ADRs were mild, 45 (51.7%) were moderate, and 1 (1.2%) was severe. The most commonly reported ADRs were related to the CNS (163, 52%). ADRs led to non-adherence in 16 patients (16.3%) in the study (Chi-square = 12.1; p < 0.001).

Conclusion: The occurrence of ADRs associated with the use of ART is common and leads to non-adherence to ART among HIV patients. Adequate patient adherence counselling is therefore needed to improve adherence to ART, in addition to patient education and clinical interventions to manage ADRs.