Abacavir usage patterns and hypersensitivity reactions in the EuroSIDA cohort

Area of Science:

• Clinical Medicine
• Virology
• Pharmacology

Background:

• Abacavir (ABC) is an important antiretroviral medication for HIV treatment.
• A small percentage of individuals initiating ABC can experience severe, potentially fatal hypersensitivity reactions (HSRs).
• Understanding the utilization and HSR incidence associated with ABC is crucial for patient safety and treatment guidelines.

Purpose of the Study:

• To determine the proportion of HIV-positive individuals initiating abacavir (ABC)-based combination antiretroviral therapy (cART).
• To investigate the incidence and associated factors of HSR among individuals prescribed ABC.
• To analyze trends in ABC utilization and discontinuation over time.

Main Methods:

• Analysis of EuroSIDA cohort data from 2009-2016.
• Calculation of ABC utilization proportions within cART regimens.
• Poisson regression models to identify factors associated with ABC use and discontinuation.
• Calculation of incidence rates for ABC discontinuation due to HSR and other toxicities.

Main Results:

• 34% of 10,076 individuals received ABC-based cART between 2009-2016.
• ABC utilization varied by region, time, and patient demographics (e.g., lower in older individuals, higher with poor renal function).
• The incidence of discontinuing ABC due to reported HSR was low (0.3 per 100 person-years), with no significant associated factors identified.

Conclusions:

• Abacavir (ABC) remains a commonly utilized antiretroviral agent across Europe.
• The incidence of discontinuing ABC due to hypersensitivity reactions (HSR) was found to be low in this study population.
• These findings support the continued use of ABC in HIV management while acknowledging the risk of HSR.