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

EuroSIDA in EuroCoord

Research output: Contribution to journalArticle

6 Citations (Scopus)

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

Fingerprint

Stavudine
HIV
Confidence Intervals
Eastern Europe
Incidence
RNA
Therapeutics
Pharmaceutical Preparations

Keywords

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

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)
  • Health Policy

Cite this

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

In: HIV Medicine, Vol. 16, No. 9, 01.10.2015, p. 533-543.

Research output: Contribution to journalArticle

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title = "Changing utilization of Stavudine (d4T) in HIV-positive people in 2006-2013 in the EuroSIDA study",
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",
keywords = "Combination antiretroviral therapy, Europe, EuroSIDA, HIV, Stavudine utilization",
author = "{EuroSIDA in EuroCoord} and D. Podlekareva and D. Grint and I. Karpov and A. Vassilenko and A. Rakmanova and K. Mansinho and N. Chentsova and E. Kravchenko and I. Zeltina and M. Losso and M. Parczewski and Jd Lundgren and A. Mocroft and O. Kirk and M. Losso and M. Kundro and N. Vetter and R. Zangerle and Mitsura, {V. M.} and O. Suetnov and N. Clumeck and {De Wit}, S. and M. Delforge and E. Florence and L. Vandekerckhove and V. Hadziosmanovic and K. Kostov and J. Begovac and L. Machala and D. Jilich and D. Sedlacek and J. Nielsen and G. Kronborg and T. Benfield and M. Larsen and J. Gerstoft and T. Katzenstein and Hansen, {A. B E} and P. Skinh{\o}j and C. Pedersen and L. Ostergaard and Dragsted, {U. B.} and Nielsen, {L. N.} and K. Zilmer and {Jelena Smidt}, Smidt and M. Ristola and C. Katlama and Viard, {J. P.} and Girard, {P. M.} and D. B{\'a}nhegyi",
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T1 - Changing utilization of Stavudine (d4T) in HIV-positive people in 2006-2013 in the EuroSIDA study

AU - EuroSIDA in EuroCoord

AU - Podlekareva, D.

AU - Grint, D.

AU - Karpov, I.

AU - Vassilenko, A.

AU - Rakmanova, A.

AU - Mansinho, K.

AU - Chentsova, N.

AU - Kravchenko, E.

AU - Zeltina, I.

AU - Losso, M.

AU - Parczewski, M.

AU - Lundgren, Jd

AU - Mocroft, A.

AU - Kirk, O.

AU - Losso, M.

AU - Kundro, M.

AU - Vetter, N.

AU - Zangerle, R.

AU - Mitsura, V. M.

AU - Suetnov, O.

AU - Clumeck, N.

AU - De Wit, S.

AU - Delforge, M.

AU - Florence, E.

AU - Vandekerckhove, L.

AU - Hadziosmanovic, V.

AU - Kostov, K.

AU - Begovac, J.

AU - Machala, L.

AU - Jilich, D.

AU - Sedlacek, D.

AU - Nielsen, J.

AU - Kronborg, G.

AU - Benfield, T.

AU - Larsen, M.

AU - Gerstoft, J.

AU - Katzenstein, T.

AU - Hansen, A. B E

AU - Skinhøj, P.

AU - Pedersen, C.

AU - Ostergaard, L.

AU - Dragsted, U. B.

AU - Nielsen, L. N.

AU - Zilmer, K.

AU - Jelena Smidt, Smidt

AU - Ristola, M.

AU - Katlama, C.

AU - Viard, J. P.

AU - Girard, P. M.

AU - Bánhegyi, D.

PY - 2015/10/1

Y1 - 2015/10/1

N2 - 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

AB - 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

KW - Combination antiretroviral therapy

KW - Europe

KW - EuroSIDA

KW - HIV

KW - Stavudine utilization

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