title: Increased incidence of symptomatic peripheral neuropathy among adults receiving stavudine- versus zidovudine-based antiretroviral regimens in Kenya.
abstract: The incidence of peripheral neuropathy (PN) among adults initiating antiretroviral therapy (ART) containing stavudine (d4T) versus zidovudine (ZDV) is not well described. We compared 1-year incidence between d4T- and ZDV-based regimens in adults initiating ART in a programmatic setting in Kenya. Of 1,848 adults on ART, 1,579 (85 %) initiated d4T-based and 269 (15 %) initiated ZDV-based regimens. One-year incidence of symptomatic PN per 100 person-years was 21.9 (n=236) among d4T users and 6.9 (n=7) among ZDV users (P=0.0002). D4T was associated with 2.7 greater risk of PN than ZDV (adjusted hazard ratio, 2.7, P=0.009). In settings with continued d4T use, such as Africa, the effects of d4T on PN compared to ZDV should be considered when choosing ART regimens.
authors.affiliation: Department of Global Health, University of Washington, Seattle, WA 98104-2499, USA. mcgrathc@u.washington.edu
authors.forename: Christine J
authors.initials: CJ
authors.lastname: McGrath
authors.forename: Julia
authors.initials: J
authors.lastname: Njoroge
authors.forename: Grace C
authors.initials: GC
authors.lastname: John-Stewart
authors.forename: Pamela K
authors.initials: PK
authors.lastname: Kohler
authors.forename: Sarah F
authors.initials: SF
authors.lastname: Benki-Nugent
authors.forename: Joan W
authors.initials: JW
authors.lastname: Thiga
authors.forename: Anthony
authors.initials: A
authors.lastname: Etyang
authors.forename: Michael H
authors.initials: MH
authors.lastname: Chung
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007630:Kenya / Q000453:epidemiology; D008297:Male; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D011336:Probability; D012189:Retrospective Studies; D018119:Stavudine / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D015215:Zidovudine / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D019380:Anti-HIV Agents; D015215:Zidovudine; D018119:Stavudine