Changing utilization of Stavudine (d4T) in HIV-positive people in 2006-2013 in the EuroSIDA study

D. Podlekareva, D. Grint, I. Karpov, A. Vassilenko, A. Rakmanova, K. Mansinho, N. Chentsova, E. Kravchenko, I. Zeltina, M. Losso, M. Parczewski, Jd Lundgren, A. Mocroft, O. Kirk, M. Losso, M. Kundro, N. Vetter, R. Zangerle, V. M. Mitsura, O. SuetnovN. Clumeck, S. De Wit, M. Delforge, E. Florence, L. Vandekerckhove, V. Hadziosmanovic, K. Kostov, J. Begovac, L. Machala, D. Jilich, D. Sedlacek, J. Nielsen, G. Kronborg, T. Benfield, M. Larsen, J. Gerstoft, T. Katzenstein, A. B E Hansen, P. Skinhøj, C. Pedersen, L. Ostergaard, U. B. Dragsted, L. N. Nielsen, K. Zilmer, Smidt Jelena Smidt, M. Ristola, C. Katlama, J. P. Viard, P. M. Girard, P. Vanhems, C. Pradier, F. Dabis, D. Neau, C. Duvivier, J. Rockstroh, [No Value] Schmidt, J. van Lunzen, O. Degen, H. J. Stellbrink, M. Bickel, J. W. Goethe, J. Bogner, G. Fätkenheuer, J. Kosmidis, P. Gargalianos, G. Xylomenos, J. Perdios, H. Sambatakou, D. Banhegyi, M. Gottfredsson, F. Mulcahy, I. Yust, D. Turner, M. Burke, S. Pollack, G. Hassoun, H. Elinav, M. Haouzi, A. D'Arminio Monforte, R. Esposito, I. Mazeu, C. Mussini, C. Arici, R. Pristera, F. Mazzotta, A. Gabbuti, V. Vullo, M. Lichtner, A. Chirianni, E. Montesarchio, M. Gargiulo, G. D'Offizi, C. Taibi, A. Antinori, A. Lazzarin, A. Castagna, N. Gianotti, M. Galli, A. Ridolfo, B. Rozentale, I. Zeltina, S. Chaplinskas, T. Staub, R. Hemmer, P. Reiss, V. Ormaasen, A. Maeland, J. Bruun, B. Knysz, J. Gasiorowski, A. Horban, E. Bakowska, A. Grzeszczuk, R. Flisiak, Boron-Kaczmarska A. Boron-Kaczmarska, M. Pynka, M. Parczewski, M. Beniowski, E. Mularska, H. Trocha, E. Jablonowska, E. Malolepsza, K. Wojcik, M. Doroana, M. Doroana, L. Caldeira, F. Maltez, D. Duiculescu, A. Rakhmanova, S. Buzunova, I. Khromova, E. Kuzovatova, D. Jevtovic, M. Mokráš, D. Staneková, J. Tomazic, J. González-Lahoz, V. Soriano, P. Labarga, S. Moreno, J. M. Rodriguez, B. Clotet, A. Jou, R. Paredes, C. Tural, J. Puig, I. Bravo, J. M. Gatell, J. M. Miró, P. Domingo, M. Gutierrez, G. Mateo, M. A. Sambeat, J. Medrano, A. Blaxhult, L. Flamholc, A. Thalme, A. Sonnerborg, B. Ledergerber, R. Weber, P. Francioli, M. Cavassini, B. Hirschel, E. Boffi, H. Furrer, M. Battegay, L. Elzi, P. Vernazza, V. Frolov, G. Kutsyna, S. Servitskiy, A. Kuznetsova, G. Kyselyova, B. Gazzard, A. M. Johnson, E. Simons, A. Phillips, M. A. Johnson, A. Mocroft, C. Orkin, J. Weber, G. Scullard, M. Fisher, C. Leen

Research output: Contribution to journalArticle

Abstract

Objectives: The long-term side effects of stavudine (d4T) led to recommendations in 2009 to phase out use of this drug. We aimed to describe temporal patterns of d4T use across Europe. Methods: Patients taking combination antiretroviral therapy (cART) in EuroSIDA with follow-up after 1 January 2006 were included in the study. cART was defined as d4T-containing [d4T plus at least two other antiretrovirals (ARVs) from any class] or non-d4T-containing (at least three ARVs from any class, excluding d4T). Poisson regression was used to describe temporal changes in the prevalence of d4T use and factors associated with initiating d4T. Results: A total of 5850 patients receiving cART on 1 January 2006 were included in the current analysis, rising to 7768 patients on January 1 2013. During this time, the prevalence of d4T use fell from 11.2% to 0.7%, with an overall decline of 19% per 6 months [95% confidence interval (CI) 19-20%]. d4T use declined fastest in Northern Europe [26% (95% CI 23-29%) per 6 months], and slowest in Eastern Europe [17% (95% CI 16-19%) per 6 months]. In multivariable Poisson regression models, new d4T initiations decreased by 14% per 6 months [adjusted incidence rate ratio (aIRR) 0.86; 95% CI 0.80-0.91]. Factors associated with initiating d4T were residence in Eastern Europe (aIRR 4.31; 95% CI 2.17-9.98) versus other European regions and HIV RNA>400 copies/mL (aIRR 3.11; 95% CI 1.60-6.02) versus HIV RNA

Original languageEnglish
Pages (from-to)533-543
Number of pages11
JournalHIV Medicine
Volume16
Issue number9
DOIs
Publication statusPublished - Oct 1 2015

Keywords

  • Combination antiretroviral therapy
  • Europe
  • EuroSIDA
  • HIV
  • Stavudine utilization

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)
  • Health Policy

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    Podlekareva, D., Grint, D., Karpov, I., Vassilenko, A., Rakmanova, A., Mansinho, K., Chentsova, N., Kravchenko, E., Zeltina, I., Losso, M., Parczewski, M., Lundgren, J., Mocroft, A., Kirk, O., Losso, M., Kundro, M., Vetter, N., Zangerle, R., Mitsura, V. M., ... Leen, C. (2015). Changing utilization of Stavudine (d4T) in HIV-positive people in 2006-2013 in the EuroSIDA study. HIV Medicine, 16(9), 533-543. https://doi.org/10.1111/hiv.12254