Changing utilization of Stavudine (d4T) in HIV-positive people in 2006–2013 in the EuroSIDA study. HIV Medicine
Podlekareva et al. aimed to describe temporal patterns of Stavudine (d4T) use across Europe from 2006 to 2013 in HIV-positive patients. Of note, d4T is associated with serious long-term side effects, e.g. mitochondrial toxicity resulting in lactic acidosis, polyneuropathy and lipodystrophy. The proportion of patients on d4T-based antiretroviral therapy decreased from 11.2% to 0.7% over the study-period. However, 2.3% of patients in Eastern Europe were still treated with d4T in 2013, reflecting a 4-fold higher risk being treated with d4T compared to other regions in Europe. Having a HIV RNA > 400 copies/mL was associated with initiating d4T.
In conclusion, there is still a low but persistent proportion of HIV positive patients in Eastern Europe receiving d4T. All HIV clinicians should be aware of the potential harmful effects associated with d4T treatment and avoid the drug as far as possible.