Naslov
Trends in the prescription of antiretroviral drugs in Croatia, 2005-2017

Autori
Begovac, Josip ; Matković, Iva ; Zekan, Šime ; Lukas, Davorka

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Skup
29th ECCMID 2019

Mjesto i datum
Amsterdam, Nizozemska, 13.04.2019. - 16.04.2019

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Antiretroviral drugs ; Croatia

Sažetak
Background: In Croatia, HIV-careincluding antiretroviral therapy (ART) is provided ata single institution, the University Hospital of Infectious Diseases (UHID) in Zagreb. We describe whether and when an apparent change in the trend in the prevalence of ART prescriptions occurred from January 2005 to December 2017. Materials/methods: Included were all patients who have been given ART from the hospital pharmacy at UHID. ART was categorized: 1) 2NRTI+1NNRTI, 2) 2NRTI+1PI, 3) 2NRTI+1INSTIand 4) other combinations. The nucleoside backbone was categorized: 1) D4T+3TC, 2) ZDV+3TC, 3) TDF+FTC, 4) ABC+3TC and 5) other combinations including nucleoside-sparing regiments. For each calendar year the total number of person-years on ART was calculated and the percent of time spent on a particular drug combination was calculated. Trends are described by Annual Percent Change (APC) using the Joinpoint Regression Program. Results: A total of 1296 (88.9% males) persons received ART at UHID in the period 2005-2017 with a total of 7216.8 person-years of follow-up. There were 226.0 person-years of therapy in 2005 and 1032.2 in 2017 (average annual increase=13.5%). The prevalence of standard 3-drug therapy (2NRTI plus one other agent of the NNRTI, PI or INSTI class) was >90% in each year except in 2017 when it was 88%. There have been significant changes in ART prescriptions particularly after 2015 with an increasing use of integrase inhibitors and non- standard ART (Figure).The use of NNRTI has decreased since 2015 where as the use of PI had a decreasing trend since 2010 (Figure). Some of the ART prescriptions were influenced by costand availability (TDF/FTC and ABC/3TC). There were 36 different combinations used by 265 patients in 2007 and 51 used by 1116 patients in 2017. Among non standard combinations, use of lopinavir-mono therapy was most prevalent before 2015 (14.6% of person-years of non-standard ART usage), afterwards it was dolutegravir plus lamivudine (36.9%). Conclusions: Our complete national data indicate significant changes in antiretroviral drug usage over time, particularly after 2015. Changes in ART were not abrupt. Among non-standard regiments non- NRTI or single-NRTI (3TC) ones were most prevalent indicating that they were prescribed mostly because of tolerability and side-effects.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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