| Title | Incidence of abacavir hypersensitivity reactions in euroSIDA. | | Author(s) | Bannister WP, Friis-Møller N, Mocroft A, Viard JP, van Lunzen J, Kirk O, Gargalianos P, Bánhegyi D, Chiesi A, Lundgren JD, EuroSIDA Study Group | | Institution | Royal Free and University College Medical School, London, UK. w.bannister@pcps.ucl.ac.uk | | Source | Antivir Ther 2008; 13(5):687-96. | | MeSH | Adult
Anti-HIV Agents
Cohort Studies
Dideoxynucleosides
Drug Administration Schedule
Drug Hypersensitivity
Drug Therapy, Combination
Europe
Female
HIV Infections
HIV-1
Humans
Incidence
Lamivudine
Male
Middle Aged
Poisson Distribution
Reverse Transcriptase Inhibitors
Treatment Outcome
Zidovudine
| | Abstract | BACKGROUND: The aim of the study was to investigate the incidence of abacavir-related hypersensitivity reaction (HSR) and associated deaths in EuroSIDA HIV-1-infected patients.
METHODS: Poisson regression models were developed to compare incidence of abacavir discontinuation according to the line of therapy within which abacavir was received, geographical regions, calendar time and drug formulation (abacavir/lamivudine combination tablet versus abacavir as a single drug or abacavir/zidovudine/lamivudine combination).
RESULTS: Of 3,278 patients that started abacavir, 2,101 (64.1%) discontinued. Of these, 167 (5.1%) discontinued abacavir within 3 months due to HSR with an incidence of 22.1 (95% confidence interval [CI] 18.7-25.4) per 100 person-years of follow-up. After adjustment for gender, prior AIDS, hepatitis C serostatus, baseline CD4+ T-cell count, region and calendar time, HSR incidence was significantly higher in those starting abacavir in a first-line regimen compared with second-line (incidence rate ratio [IRR] 2.04 [95% CI 1.24-3.38]; P=0.005). There was no significant difference between regions. HSR incidence from 2005 onwards was significantly lower compared with 1999-2000 (IRR 0.54 [95% CI 0.32-0.92]; P=0.024). There was a lower observed incidence in patients starting abacavir/lamivudine compared with other formulations (IRR 0.33 [95% CI 0.13-0.88]; P=0.027), however, available data were limited.
CONCLUSIONS: Incidence of abacavir-related HSR is higher in patients starting abacavir in first-line therapy, which could indicate increased over-diagnosis. HSR incidence has decreased in recent years, which might reflect the wider availability of genetic screening and improved awareness of symptoms. There were no reported deaths due to abacavir HSR. | | Language | eng | | Pub Type(s) | Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
| | PubMed ID | 18771052 |
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