PMID- 24552395
OWN - NLM
STAT- MEDLINE
DCOM- 20141218
LR  - 20231110
IS  - 1471-2334 (Electronic)
IS  - 1471-2334 (Linking)
VI  - 14
DP  - 2014 Feb 20
TI  - cART prescription trends in a prospective HIV cohort in rural Tanzania from 2007 
      to 2011.
PG  - 90
LID - 10.1186/1471-2334-14-90 [doi]
AB  - BACKGROUND: Since 2010, World Health Organization (WHO) guidelines discourage 
      using stavudine in first-line regimens due to frequent and severe side effects. 
      This study describes the implementation of this recommendation and trends in 
      usage of antiretroviral therapy combinations in a cohort of HIV-positive patients 
      in rural Tanzania. METHODS: We analyzed longitudinal, prospectively collected 
      clinical data of HIV-1 infected adults initiating antiretroviral therapy within 
      the Kilombero Ulanga Antiretroviral Cohort (KIULARCO) in Ifakara, Tanzania from 
      2007-2011. RESULTS: This analysis included data of 3008 patients. Median age was 
      38 (interquartile range [IQR] 31-45) years, 1962 (65.2%) of all subjects were 
      female, and median CD4+ cell count at enrollment was 168 cells/mm3 (IQR 81-273). 
      The percentage of prescriptions containing stavudine in initial regimens fell 
      from a maximum of 75.3% in 2008 to 10.7% in 2011. TDF/FTC/EFV became available in 
      2009 and was used in 41.9% of patients initiating cART in 2011. An overall 
      on-treatment analysis revealed that d4T/3TC/NVP and AZT/3TC/EFV were the most 
      prescribed combinations in each year, including 2011 (674 [36.5%] and 641 [34.7%] 
      patients, respectively). Of those receiving stavudine in 2011, 659 (89.1%) 
      initiated it before 2011. CONCLUSIONS: Initial cART with stavudine declined to 
      low levels according to recommendations but the overall use of stavudine remained 
      substantial, as individuals already on cART containing stavudine were not changed 
      to alternative drugs. Our findings highlight the critical need to exchange 
      stavudine in treatment regimens of patients who initiated therapy in earlier 
      years.
FAU - Franzeck, Fabian Christoph
AU  - Franzeck FC
AD  - Swiss Tropical and Public Health Institute (SwissTPH), Socinstrasse 57, CH-4051 
      Basel, Switzerland. fcfranzeck@gmail.com.
FAU - Letang, Emilio
AU  - Letang E
FAU - Mwaigomole, Geoffrey
AU  - Mwaigomole G
FAU - Jullu, Boniphace
AU  - Jullu B
FAU - Glass, Tracy R
AU  - Glass TR
FAU - Nyogea, Daniel
AU  - Nyogea D
FAU - Hatz, Christoph
AU  - Hatz C
FAU - Tanner, Marcel
AU  - Tanner M
FAU - Battegay, Manuel
AU  - Battegay M
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140220
PL  - England
TA  - BMC Infect Dis
JT  - BMC infectious diseases
JID - 100968551
RN  - 0 (Anti-HIV Agents)
RN  - BO9LE4QFZF (Stavudine)
SB  - IM
MH  - Adult
MH  - Anti-HIV Agents/*therapeutic use
MH  - CD4 Lymphocyte Count
MH  - CD4-Positive T-Lymphocytes/cytology
MH  - Drug Prescriptions/*statistics & numerical data
MH  - Female
MH  - HIV Infections/*drug therapy
MH  - HIV Seropositivity/drug therapy
MH  - HIV-1
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Practice Guidelines as Topic
MH  - Prospective Studies
MH  - Rural Population
MH  - Stavudine/*therapeutic use
MH  - Tanzania
PMC - PMC3936899
EDAT- 2014/02/21 06:00
MHDA- 2014/12/19 06:00
PMCR- 2014/02/20
CRDT- 2014/02/21 06:00
PHST- 2013/06/19 00:00 [received]
PHST- 2014/02/18 00:00 [accepted]
PHST- 2014/02/21 06:00 [entrez]
PHST- 2014/02/21 06:00 [pubmed]
PHST- 2014/12/19 06:00 [medline]
PHST- 2014/02/20 00:00 [pmc-release]
AID - 1471-2334-14-90 [pii]
AID - 10.1186/1471-2334-14-90 [doi]
PST - epublish
SO  - BMC Infect Dis. 2014 Feb 20;14:90. doi: 10.1186/1471-2334-14-90.