Patterns of efavirenz use as first-line antiretroviral therapy in the United States: 1999-2015
Efavirenz has been a mainstay of antiretroviral therapy (ART) for over 15 years in the US. Its association with neuropsychiatric side effects may influence clinical prescribing and management. We included HIV-infected adults enrolled in care at seven sites across the US, who initiated combination AR...
Gespeichert in:
| Veröffentlicht in: | Antiviral therapy 2018-01, Vol.23 (4), p.363-372 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 372 |
|---|---|
| container_issue | 4 |
| container_start_page | 363 |
| container_title | Antiviral therapy |
| container_volume | 23 |
| creator | Bengtson, Angela M Pence, Brian W Eaton, Ellen F Edwards, Jessie K Eron, Joseph J Mathews, William C Mollan, Katie Moore, Richard D O'Cleirigh, Connall Geng, Elvin Mugavero, Michael J |
| description | Efavirenz has been a mainstay of antiretroviral therapy (ART) for over 15 years in the US. Its association with neuropsychiatric side effects may influence clinical prescribing and management.
We included HIV-infected adults enrolled in care at seven sites across the US, who initiated combination ART between 1999 and 2015. We examined the proportion initiating and continuing on efavirenz, overall and by mental health status. Log binomial and Cox models were used to estimate associations between mental health, clinical and sociodemographic characteristics and initiating or switching from efavirenz as first-line ART.
Of the 8,230 participants included, 3,710 (45%) initiated efavirenz. In multivariable analyses, prior mono- or dual-ART, ART initiation after 2006, being female, intravenous drug use, antidepressant prescription, previous mental health diagnosis and baseline CD4
T-cell count >350 cells/mm
were inversely associated with initiating efavirenz. Participants initiating efavirenz had a faster time to a regimen switch, compared with those initiating an efavirenz-free regimen (P-value |
| doi_str_mv | 10.3851/IMP3223 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6085156</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2155913346</sourcerecordid><originalsourceid>FETCH-LOGICAL-c397t-b4c5b5901123b397f619b831676a045755e6ab986878aa47eecb531c3b620ea83</originalsourceid><addsrcrecordid>eNpdkVtLAzEQhYMotlbxH0jAB31ZzWWT3fggiHiDigX11ZDdzmrKNluTrKC_3hSrqE-ZZD7OnMxBaJeSI14KenxzO-GM8TU0ZCQnGSOiXEdDyoXKpOBigLZCmBHCSkXIJhowlbNcqmKIniYmRvAu4K7B0Jg368F94D4ANgE31oeYtdalm4upFX2XCNPi-ALeLN6xdcsSPzobYYrvo4kQTjBVSiUTVGyjjca0AXZW5wg9Xl48nF9n47urm_OzcVZzVcSsymtRCUUoZbxKL42kqio5lYU0JBeFECBNpUpZFqUxeQFQV4LTmleSETAlH6HTL91FX81hWoOLyaVeeDs3_l13xuq_HWdf9HP3piVJ6xMyCRyuBHz32kOIem5DDW1rHHR90IwQSiQTajlr_x8663rv0vc0o0Ioynm-FDz4omrfheCh-TFDiV5mpleZJXLvt_cf7jsk_gkASo-y</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2155913346</pqid></control><display><type>article</type><title>Patterns of efavirenz use as first-line antiretroviral therapy in the United States: 1999-2015</title><source>MEDLINE</source><source>Sage Journals GOLD Open Access 2024</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Bengtson, Angela M ; Pence, Brian W ; Eaton, Ellen F ; Edwards, Jessie K ; Eron, Joseph J ; Mathews, William C ; Mollan, Katie ; Moore, Richard D ; O'Cleirigh, Connall ; Geng, Elvin ; Mugavero, Michael J</creator><creatorcontrib>Bengtson, Angela M ; Pence, Brian W ; Eaton, Ellen F ; Edwards, Jessie K ; Eron, Joseph J ; Mathews, William C ; Mollan, Katie ; Moore, Richard D ; O'Cleirigh, Connall ; Geng, Elvin ; Mugavero, Michael J</creatorcontrib><description>Efavirenz has been a mainstay of antiretroviral therapy (ART) for over 15 years in the US. Its association with neuropsychiatric side effects may influence clinical prescribing and management.
We included HIV-infected adults enrolled in care at seven sites across the US, who initiated combination ART between 1999 and 2015. We examined the proportion initiating and continuing on efavirenz, overall and by mental health status. Log binomial and Cox models were used to estimate associations between mental health, clinical and sociodemographic characteristics and initiating or switching from efavirenz as first-line ART.
Of the 8,230 participants included, 3,710 (45%) initiated efavirenz. In multivariable analyses, prior mono- or dual-ART, ART initiation after 2006, being female, intravenous drug use, antidepressant prescription, previous mental health diagnosis and baseline CD4
T-cell count >350 cells/mm
were inversely associated with initiating efavirenz. Participants initiating efavirenz had a faster time to a regimen switch, compared with those initiating an efavirenz-free regimen (P-value <0.01). Among efavirenz initiators, starting efavirenz in more recent time periods and a previous mental health diagnosis were associated with faster time to switching from efavirenz. Despite this, 40-50% of participants with a previous mental health diagnosis initiated and continued on efavirenz for much of the follow-up period.
Multiple clinical factors, including mental health diagnoses, appeared to influence efavirenz use. While mental health diagnosis status and more recent treatment starts were associated with shorter duration of efavirenz therapy, a previous mental health diagnosis did not preclude efavirenz initiation or continuation in many participants.</description><identifier>ISSN: 1359-6535</identifier><identifier>EISSN: 2040-2058</identifier><identifier>DOI: 10.3851/IMP3223</identifier><identifier>PMID: 29424697</identifier><language>eng</language><publisher>England: International Medical Press</publisher><subject>Adult ; Alkynes ; Anti-HIV Agents - therapeutic use ; Antiretroviral drugs ; Antiretroviral therapy ; Antiretroviral Therapy, Highly Active ; Benzoxazines - therapeutic use ; CD4 antigen ; CD4 Lymphocyte Count ; Cyclopropanes ; Diagnosis ; Drug therapy ; Efavirenz ; Female ; History, 20th Century ; History, 21st Century ; HIV ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; HIV Infections - history ; HIV Infections - virology ; Human immunodeficiency virus ; Humans ; Intravenous administration ; Lymphocytes T ; Male ; Mental health ; Middle Aged ; Practice Patterns, Physicians ; United States - epidemiology ; Viral Load</subject><ispartof>Antiviral therapy, 2018-01, Vol.23 (4), p.363-372</ispartof><rights>Copyright International Medical Press 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c397t-b4c5b5901123b397f619b831676a045755e6ab986878aa47eecb531c3b620ea83</citedby><cites>FETCH-LOGICAL-c397t-b4c5b5901123b397f619b831676a045755e6ab986878aa47eecb531c3b620ea83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29424697$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bengtson, Angela M</creatorcontrib><creatorcontrib>Pence, Brian W</creatorcontrib><creatorcontrib>Eaton, Ellen F</creatorcontrib><creatorcontrib>Edwards, Jessie K</creatorcontrib><creatorcontrib>Eron, Joseph J</creatorcontrib><creatorcontrib>Mathews, William C</creatorcontrib><creatorcontrib>Mollan, Katie</creatorcontrib><creatorcontrib>Moore, Richard D</creatorcontrib><creatorcontrib>O'Cleirigh, Connall</creatorcontrib><creatorcontrib>Geng, Elvin</creatorcontrib><creatorcontrib>Mugavero, Michael J</creatorcontrib><title>Patterns of efavirenz use as first-line antiretroviral therapy in the United States: 1999-2015</title><title>Antiviral therapy</title><addtitle>Antivir Ther</addtitle><description>Efavirenz has been a mainstay of antiretroviral therapy (ART) for over 15 years in the US. Its association with neuropsychiatric side effects may influence clinical prescribing and management.
We included HIV-infected adults enrolled in care at seven sites across the US, who initiated combination ART between 1999 and 2015. We examined the proportion initiating and continuing on efavirenz, overall and by mental health status. Log binomial and Cox models were used to estimate associations between mental health, clinical and sociodemographic characteristics and initiating or switching from efavirenz as first-line ART.
Of the 8,230 participants included, 3,710 (45%) initiated efavirenz. In multivariable analyses, prior mono- or dual-ART, ART initiation after 2006, being female, intravenous drug use, antidepressant prescription, previous mental health diagnosis and baseline CD4
T-cell count >350 cells/mm
were inversely associated with initiating efavirenz. Participants initiating efavirenz had a faster time to a regimen switch, compared with those initiating an efavirenz-free regimen (P-value <0.01). Among efavirenz initiators, starting efavirenz in more recent time periods and a previous mental health diagnosis were associated with faster time to switching from efavirenz. Despite this, 40-50% of participants with a previous mental health diagnosis initiated and continued on efavirenz for much of the follow-up period.
Multiple clinical factors, including mental health diagnoses, appeared to influence efavirenz use. While mental health diagnosis status and more recent treatment starts were associated with shorter duration of efavirenz therapy, a previous mental health diagnosis did not preclude efavirenz initiation or continuation in many participants.</description><subject>Adult</subject><subject>Alkynes</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Benzoxazines - therapeutic use</subject><subject>CD4 antigen</subject><subject>CD4 Lymphocyte Count</subject><subject>Cyclopropanes</subject><subject>Diagnosis</subject><subject>Drug therapy</subject><subject>Efavirenz</subject><subject>Female</subject><subject>History, 20th Century</subject><subject>History, 21st Century</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - history</subject><subject>HIV Infections - virology</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Intravenous administration</subject><subject>Lymphocytes T</subject><subject>Male</subject><subject>Mental health</subject><subject>Middle Aged</subject><subject>Practice Patterns, Physicians</subject><subject>United States - epidemiology</subject><subject>Viral Load</subject><issn>1359-6535</issn><issn>2040-2058</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkVtLAzEQhYMotlbxH0jAB31ZzWWT3fggiHiDigX11ZDdzmrKNluTrKC_3hSrqE-ZZD7OnMxBaJeSI14KenxzO-GM8TU0ZCQnGSOiXEdDyoXKpOBigLZCmBHCSkXIJhowlbNcqmKIniYmRvAu4K7B0Jg368F94D4ANgE31oeYtdalm4upFX2XCNPi-ALeLN6xdcsSPzobYYrvo4kQTjBVSiUTVGyjjca0AXZW5wg9Xl48nF9n47urm_OzcVZzVcSsymtRCUUoZbxKL42kqio5lYU0JBeFECBNpUpZFqUxeQFQV4LTmleSETAlH6HTL91FX81hWoOLyaVeeDs3_l13xuq_HWdf9HP3piVJ6xMyCRyuBHz32kOIem5DDW1rHHR90IwQSiQTajlr_x8663rv0vc0o0Ioynm-FDz4omrfheCh-TFDiV5mpleZJXLvt_cf7jsk_gkASo-y</recordid><startdate>20180101</startdate><enddate>20180101</enddate><creator>Bengtson, Angela M</creator><creator>Pence, Brian W</creator><creator>Eaton, Ellen F</creator><creator>Edwards, Jessie K</creator><creator>Eron, Joseph J</creator><creator>Mathews, William C</creator><creator>Mollan, Katie</creator><creator>Moore, Richard D</creator><creator>O'Cleirigh, Connall</creator><creator>Geng, Elvin</creator><creator>Mugavero, Michael J</creator><general>International Medical Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180101</creationdate><title>Patterns of efavirenz use as first-line antiretroviral therapy in the United States: 1999-2015</title><author>Bengtson, Angela M ; Pence, Brian W ; Eaton, Ellen F ; Edwards, Jessie K ; Eron, Joseph J ; Mathews, William C ; Mollan, Katie ; Moore, Richard D ; O'Cleirigh, Connall ; Geng, Elvin ; Mugavero, Michael J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c397t-b4c5b5901123b397f619b831676a045755e6ab986878aa47eecb531c3b620ea83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Alkynes</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antiretroviral drugs</topic><topic>Antiretroviral therapy</topic><topic>Antiretroviral Therapy, Highly Active</topic><topic>Benzoxazines - therapeutic use</topic><topic>CD4 antigen</topic><topic>CD4 Lymphocyte Count</topic><topic>Cyclopropanes</topic><topic>Diagnosis</topic><topic>Drug therapy</topic><topic>Efavirenz</topic><topic>Female</topic><topic>History, 20th Century</topic><topic>History, 21st Century</topic><topic>HIV</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - epidemiology</topic><topic>HIV Infections - history</topic><topic>HIV Infections - virology</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Intravenous administration</topic><topic>Lymphocytes T</topic><topic>Male</topic><topic>Mental health</topic><topic>Middle Aged</topic><topic>Practice Patterns, Physicians</topic><topic>United States - epidemiology</topic><topic>Viral Load</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bengtson, Angela M</creatorcontrib><creatorcontrib>Pence, Brian W</creatorcontrib><creatorcontrib>Eaton, Ellen F</creatorcontrib><creatorcontrib>Edwards, Jessie K</creatorcontrib><creatorcontrib>Eron, Joseph J</creatorcontrib><creatorcontrib>Mathews, William C</creatorcontrib><creatorcontrib>Mollan, Katie</creatorcontrib><creatorcontrib>Moore, Richard D</creatorcontrib><creatorcontrib>O'Cleirigh, Connall</creatorcontrib><creatorcontrib>Geng, Elvin</creatorcontrib><creatorcontrib>Mugavero, Michael J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Antiviral therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bengtson, Angela M</au><au>Pence, Brian W</au><au>Eaton, Ellen F</au><au>Edwards, Jessie K</au><au>Eron, Joseph J</au><au>Mathews, William C</au><au>Mollan, Katie</au><au>Moore, Richard D</au><au>O'Cleirigh, Connall</au><au>Geng, Elvin</au><au>Mugavero, Michael J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patterns of efavirenz use as first-line antiretroviral therapy in the United States: 1999-2015</atitle><jtitle>Antiviral therapy</jtitle><addtitle>Antivir Ther</addtitle><date>2018-01-01</date><risdate>2018</risdate><volume>23</volume><issue>4</issue><spage>363</spage><epage>372</epage><pages>363-372</pages><issn>1359-6535</issn><eissn>2040-2058</eissn><abstract>Efavirenz has been a mainstay of antiretroviral therapy (ART) for over 15 years in the US. Its association with neuropsychiatric side effects may influence clinical prescribing and management.
We included HIV-infected adults enrolled in care at seven sites across the US, who initiated combination ART between 1999 and 2015. We examined the proportion initiating and continuing on efavirenz, overall and by mental health status. Log binomial and Cox models were used to estimate associations between mental health, clinical and sociodemographic characteristics and initiating or switching from efavirenz as first-line ART.
Of the 8,230 participants included, 3,710 (45%) initiated efavirenz. In multivariable analyses, prior mono- or dual-ART, ART initiation after 2006, being female, intravenous drug use, antidepressant prescription, previous mental health diagnosis and baseline CD4
T-cell count >350 cells/mm
were inversely associated with initiating efavirenz. Participants initiating efavirenz had a faster time to a regimen switch, compared with those initiating an efavirenz-free regimen (P-value <0.01). Among efavirenz initiators, starting efavirenz in more recent time periods and a previous mental health diagnosis were associated with faster time to switching from efavirenz. Despite this, 40-50% of participants with a previous mental health diagnosis initiated and continued on efavirenz for much of the follow-up period.
Multiple clinical factors, including mental health diagnoses, appeared to influence efavirenz use. While mental health diagnosis status and more recent treatment starts were associated with shorter duration of efavirenz therapy, a previous mental health diagnosis did not preclude efavirenz initiation or continuation in many participants.</abstract><cop>England</cop><pub>International Medical Press</pub><pmid>29424697</pmid><doi>10.3851/IMP3223</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1359-6535 |
| ispartof | Antiviral therapy, 2018-01, Vol.23 (4), p.363-372 |
| issn | 1359-6535 2040-2058 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6085156 |
| source | MEDLINE; Sage Journals GOLD Open Access 2024; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adult Alkynes Anti-HIV Agents - therapeutic use Antiretroviral drugs Antiretroviral therapy Antiretroviral Therapy, Highly Active Benzoxazines - therapeutic use CD4 antigen CD4 Lymphocyte Count Cyclopropanes Diagnosis Drug therapy Efavirenz Female History, 20th Century History, 21st Century HIV HIV Infections - drug therapy HIV Infections - epidemiology HIV Infections - history HIV Infections - virology Human immunodeficiency virus Humans Intravenous administration Lymphocytes T Male Mental health Middle Aged Practice Patterns, Physicians United States - epidemiology Viral Load |
| title | Patterns of efavirenz use as first-line antiretroviral therapy in the United States: 1999-2015 |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-30T14%3A04%3A43IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Patterns%20of%20efavirenz%20use%20as%20first-line%20antiretroviral%20therapy%20in%20the%20United%20States:%201999-2015&rft.jtitle=Antiviral%20therapy&rft.au=Bengtson,%20Angela%20M&rft.date=2018-01-01&rft.volume=23&rft.issue=4&rft.spage=363&rft.epage=372&rft.pages=363-372&rft.issn=1359-6535&rft.eissn=2040-2058&rft_id=info:doi/10.3851/IMP3223&rft_dat=%3Cproquest_pubme%3E2155913346%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2155913346&rft_id=info:pmid/29424697&rfr_iscdi=true |