Lars Jørgen Østergaard

Abacavir usage patterns and hypersensitivity reactions in the EuroSIDA cohort

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

DOI

  • A Roen, University College London, London
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  • K Laut, University of Copenhagen
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  • A Pelchen-Matthews, University College London, London
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  • E Borodulina, Samara State Medical University, Samara, Russia.
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  • L Caldeira, Hospital Santa Maria, Lisbon, Portugal.
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  • A Clarke, Royal Sussex County Hospital, Brighton, UK.
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  • B Clotet, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
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  • A d'Arminio Monforte, Ospedale San Paulo, Milan, Italy.
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  • G Fätkenheuer, University Hospital of Cologne, Cologne, Germany.
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  • J M Gatell Artigas, Department of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain; Multidisciplinary Sleep Unit, Hospital Clínic de Barcelona, Barcelona, Spain.
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  • I Karpov, Belarus State Medical University, Minsk, Belarus.
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  • A Kuznetsova, Kharkov State Medical University, Khrakov, Ukraine.
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  • G Kyselyova, Crimean Republican AIDS Centre, Simferopol, Ukraine.
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  • I Mozer-Lisewska, Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Collegium Maius, Fredry 10, 61-701, Poznań, Poland.
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  • F Mulcahy, Neuropsychiatric Genetics Group, Department of Psychiatry, Trinity College Dublin, St James Hospital, Dublin, Ireland.
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  • L Ragone, ViiV Healthcare, Research Triangle Park, NC, USA.
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  • A Scherrer, Department of Cardiology, University Hospital of Zurich, Zurich, Switzerland.
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  • V Uzdaviniene, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania.
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  • L Vandekerckhove, Universitair Ziekenhuis Gent (Ghent University Hospital), Gent, Belgium; Representative of the European Heart Rhythm Association (EHRA).
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  • V Vannappagari, ViiV Healthcare, Research Triangle Park, NC, USA.
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  • L Ostergaard
  • A Mocroft, University College London, London
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  • EuroSIDA study

OBJECTIVES: Five to eight per cent of HIV-positive individuals initiating abacavir (ABC) experience potentially fatal hypersensitivity reactions (HSRs). We sought to describe the proportion of individuals initiating ABC and to describe the incidence and factors associated with HSR among those prescribed ABC.

METHODS: We calculated the proportion of EuroSIDA individuals receiving ABC-based combination antiretroviral therapy (cART) among those receiving cART after 1 January 2009. Poisson regression was used to identify demographic, and current clinical and laboratory factors associated with ABC utilization and discontinuation.

RESULTS: Between 2009 and 2016, of 10 076 individuals receiving cART, 3472 (34%) had ever received ABC-based cART. Temporal trends of ABC utilization were also heterogeneous, with 28% using ABC in 2009, dropping to 26% in 2010 and increasing to 31% in 2016, and varied across regions and over time. Poisson models showed lower ABC utilization in older individuals, and in those with higher CD4 cell counts, higher cART lines, and prior AIDS. Higher ABC utilization was associated with higher HIV RNA and poor renal function, and was more common in Central-East and Eastern Europe and lowest during 2014. During 779 person-years of follow-up (PYFU) in 2139 individuals starting ABC after 1 January 2009, 113 discontinued ABC within 6 weeks of initiation for any reason [incidence rate (IR) 14.5 (95% confidence interval (CI) 12.1, 17.5) per 100 PYFU], 13 because of reported HSR [IR 0.3 (95% CI 0.1, 1.0) per 100 PYFU] and 35 because of reported HSR/any toxicity [IR 4.5 (95% CI 3.2, 6.3) per 100 PYFU]. There were no factors significantly associated with ABC discontinuation because of reported HSR/any toxicity.

CONCLUSIONS: ABC remains commonly used across Europe and the incidence of discontinuation because of reported HSR was low in our study population.

Original languageEnglish
JournalHIV Medicine
Volume19
Issue4
Pages (from-to)252-260
Number of pages9
ISSN1464-2662
DOIs
Publication statusPublished - Apr 2018

    Research areas

  • abacavir, HIV, hypersensitivity reaction

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