Frequency of stavudine substitution due to toxicity in children receiving antiretroviral treatment in sub-Saharan Africa.
Identifieur interne : 001199 ( PubMed/Corpus ); précédent : 001198; suivant : 001200Frequency of stavudine substitution due to toxicity in children receiving antiretroviral treatment in sub-Saharan Africa.
Auteurs : Megan Palmer ; Matthew Chersich ; Harry Moultrie ; Louise Kuhn ; Lee Fairlie ; Tammy MeyersSource :
- AIDS (London, England) [ 1473-5571 ] ; 2013.
English descriptors
- KwdEn :
- Anti-HIV Agents (administration & dosage), Anti-HIV Agents (adverse effects), Antiretroviral Therapy, Highly Active (adverse effects), Benzoxazines (administration & dosage), Benzoxazines (adverse effects), Child, Child, Preschool, Cohort Studies, Dideoxynucleosides (administration & dosage), Dideoxynucleosides (adverse effects), Drug Substitution, Drug Therapy, Combination, Drug-Related Side Effects and Adverse Reactions (chemically induced), Female, HIV Infections (drug therapy), Humans, Infant, Lamivudine (administration & dosage), Lamivudine (adverse effects), Male, Retrospective Studies, Risk Factors, South Africa, Stavudine (administration & dosage), Stavudine (adverse effects), Time Factors.
- MESH :
- chemical , administration & dosage : Anti-HIV Agents, Benzoxazines, Dideoxynucleosides, Lamivudine, Stavudine.
- chemical , adverse effects : Anti-HIV Agents, Benzoxazines, Dideoxynucleosides, Lamivudine, Stavudine.
- geographic : South Africa.
- adverse effects : Antiretroviral Therapy, Highly Active.
- chemically induced : Drug-Related Side Effects and Adverse Reactions.
- drug therapy : HIV Infections.
- Child, Child, Preschool, Cohort Studies, Drug Substitution, Drug Therapy, Combination, Female, Humans, Infant, Male, Retrospective Studies, Risk Factors, Time Factors.
Abstract
Stavudine is a commonly used drug in paediatric antiretroviral treatment (ART) regimens. Due to toxicity concerns, however, the drug abacavir has replaced stavudine in first-line paediatric regimens in many countries. We describe the frequency of stavudine toxicity in children receiving ART at a treatment clinic in Soweto, South Africa.
DOI: 10.1097/QAD.0b013e32835c54b8
PubMed: 23169331
Links to Exploration step
pubmed:23169331Le document en format XML
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last="Fairlie">Lee Fairlie</name></author><author><name sortKey="Meyers, Tammy" sort="Meyers, Tammy" uniqKey="Meyers T" first="Tammy" last="Meyers">Tammy Meyers</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2013">2013</date><idno type="RBID">pubmed:23169331</idno><idno type="pmid">23169331</idno><idno type="doi">10.1097/QAD.0b013e32835c54b8</idno><idno type="wicri:Area/PubMed/Corpus">001199</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001199</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Frequency of stavudine substitution due to toxicity in children receiving antiretroviral treatment in sub-Saharan Africa.</title><author><name sortKey="Palmer, Megan" sort="Palmer, Megan" uniqKey="Palmer M" first="Megan" last="Palmer">Megan Palmer</name><affiliation><nlm:affiliation>Department of Paediatrics, Chris Hani Baragwanath Hospital, Johannesburg, South Africa.</nlm:affiliation></affiliation></author><author><name sortKey="Chersich, Matthew" sort="Chersich, Matthew" uniqKey="Chersich M" first="Matthew" last="Chersich">Matthew Chersich</name></author><author><name sortKey="Moultrie, Harry" sort="Moultrie, Harry" uniqKey="Moultrie H" first="Harry" last="Moultrie">Harry Moultrie</name></author><author><name sortKey="Kuhn, Louise" sort="Kuhn, Louise" uniqKey="Kuhn L" first="Louise" last="Kuhn">Louise Kuhn</name></author><author><name sortKey="Fairlie, Lee" sort="Fairlie, Lee" uniqKey="Fairlie L" first="Lee" last="Fairlie">Lee Fairlie</name></author><author><name sortKey="Meyers, Tammy" sort="Meyers, Tammy" uniqKey="Meyers T" first="Tammy" last="Meyers">Tammy Meyers</name></author></analytic><series><title level="j">AIDS (London, England)</title><idno type="eISSN">1473-5571</idno><imprint><date when="2013" type="published">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anti-HIV Agents (administration & dosage)</term><term>Anti-HIV Agents (adverse effects)</term><term>Antiretroviral Therapy, Highly Active (adverse effects)</term><term>Benzoxazines (administration & dosage)</term><term>Benzoxazines (adverse effects)</term><term>Child</term><term>Child, Preschool</term><term>Cohort Studies</term><term>Dideoxynucleosides (administration & dosage)</term><term>Dideoxynucleosides (adverse effects)</term><term>Drug Substitution</term><term>Drug Therapy, Combination</term><term>Drug-Related Side Effects and Adverse Reactions (chemically induced)</term><term>Female</term><term>HIV Infections (drug therapy)</term><term>Humans</term><term>Infant</term><term>Lamivudine (administration & dosage)</term><term>Lamivudine (adverse effects)</term><term>Male</term><term>Retrospective Studies</term><term>Risk Factors</term><term>South Africa</term><term>Stavudine (administration & dosage)</term><term>Stavudine (adverse effects)</term><term>Time Factors</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Anti-HIV Agents</term><term>Benzoxazines</term><term>Dideoxynucleosides</term><term>Lamivudine</term><term>Stavudine</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Anti-HIV Agents</term><term>Benzoxazines</term><term>Dideoxynucleosides</term><term>Lamivudine</term><term>Stavudine</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>South Africa</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Antiretroviral Therapy, Highly Active</term></keywords><keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Drug-Related Side Effects and Adverse Reactions</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Child</term><term>Child, Preschool</term><term>Cohort Studies</term><term>Drug Substitution</term><term>Drug Therapy, Combination</term><term>Female</term><term>Humans</term><term>Infant</term><term>Male</term><term>Retrospective Studies</term><term>Risk Factors</term><term>Time Factors</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Stavudine is a commonly used drug in paediatric antiretroviral treatment (ART) regimens. Due to toxicity concerns, however, the drug abacavir has replaced stavudine in first-line paediatric regimens in many countries. We describe the frequency of stavudine toxicity in children receiving ART at a treatment clinic in Soweto, South Africa.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">23169331</PMID><DateCreated><Year>2013</Year><Month>05</Month><Day>31</Day></DateCreated><DateCompleted><Year>2013</Year><Month>10</Month><Day>29</Day></DateCompleted><DateRevised><Year>2014</Year><Month>02</Month><Day>06</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1473-5571</ISSN><JournalIssue CitedMedium="Internet"><Volume>27</Volume><Issue>5</Issue><PubDate><Year>2013</Year><Month>Mar</Month><Day>13</Day></PubDate></JournalIssue><Title>AIDS (London, England)</Title><ISOAbbreviation>AIDS</ISOAbbreviation></Journal><ArticleTitle>Frequency of stavudine substitution due to toxicity in children receiving antiretroviral treatment in sub-Saharan Africa.</ArticleTitle><Pagination><MedlinePgn>781-5</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1097/QAD.0b013e32835c54b8</ELocationID><Abstract><AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">Stavudine is a commonly used drug in paediatric antiretroviral treatment (ART) regimens. Due to toxicity concerns, however, the drug abacavir has replaced stavudine in first-line paediatric regimens in many countries. We describe the frequency of stavudine toxicity in children receiving ART at a treatment clinic in Soweto, South Africa.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Data on patient characteristics and outcomes of ART were collected from a cohort of 2222 HIV-infected children initiating ART between 2004 and 2008 when stavudine-containing regimens were routinely recommended. At several time-points after treatment initiation, we estimate the proportion of children where an attending clinician discontinued stavudine due to lipodystrophy, pancreatitis, lactic acidosis or peripheral neuropathy. Factors associated with stavudine-related toxicities were identified.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">At ART initiation, most children had advanced disease. The majority initiated an efavirenz/lamivudine/stavudine regimen (n = 1422), and 76% of children remained on their initial ART regimen after a median 19.9 months of ART. Replacement of stavudine due to drug toxicity occurred at a rate of 28.8 per 1000 child years on treatment (95% confidence interval = 23.6-35.2). Rates of toxicity increased with treatment duration (in their first year of ART stavudine was replaced in 0.5% of children, but after 3 years stavudine had been changed to abacavir in 12.6% of children). Toxicity was more common in older children and in girls. Lipodystrophy accounted for 87 of 96 toxic events.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Stavudine-associated toxicity resulting in single-drug substitution was uncommon in this cohort, though its frequency increased steadily with ART duration, especially with lipodystrophy. Where drug options are limited, stavudine remains a relatively well tolerated and effective option for children.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Palmer</LastName><ForeName>Megan</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Paediatrics, Chris Hani Baragwanath Hospital, Johannesburg, South Africa.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chersich</LastName><ForeName>Matthew</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Moultrie</LastName><ForeName>Harry</ForeName><Initials>H</Initials></Author><Author ValidYN="Y"><LastName>Kuhn</LastName><ForeName>Louise</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Fairlie</LastName><ForeName>Lee</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Meyers</LastName><ForeName>Tammy</ForeName><Initials>T</Initials></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>5U2RTW007370</GrantID><Agency>PHS HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>5U2RTW007373</GrantID><Agency>PHS HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D052061">Research Support, N.I.H., Extramural</PublicationType><PublicationType UI="D013486">Research Support, U.S. Gov't, Non-P.H.S.</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>AIDS</MedlineTA><NlmUniqueID>8710219</NlmUniqueID><ISSNLinking>0269-9370</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D019380">Anti-HIV Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D048588">Benzoxazines</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D015224">Dideoxynucleosides</NameOfSubstance></Chemical><Chemical><RegistryNumber>2T8Q726O95</RegistryNumber><NameOfSubstance UI="D019259">Lamivudine</NameOfSubstance></Chemical><Chemical><RegistryNumber>BO9LE4QFZF</RegistryNumber><NameOfSubstance UI="D018119">Stavudine</NameOfSubstance></Chemical><Chemical><RegistryNumber>JE6H2O27P8</RegistryNumber><NameOfSubstance UI="C098320">efavirenz</NameOfSubstance></Chemical><Chemical><RegistryNumber>WR2TIP26VS</RegistryNumber><NameOfSubstance UI="C106538">abacavir</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><CitationSubset>X</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D019380" MajorTopicYN="N">Anti-HIV Agents</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D023241" MajorTopicYN="N">Antiretroviral Therapy, Highly 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