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Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

From pills to patients: an evaluation of data sources to determine the number of people living with HIV who are receiving antiretroviral therapy in Germany

Authors: Daniel Schmidt, Christian Kollan, Matthias Stoll, Hans-Jürgen Stellbrink, Andreas Plettenberg, Gerd Fätkenheuer, Frank Bergmann, Johannes R Bogner, Jan van Lunzen, Jürgen Rockstroh, Stefan Esser, Björn-Erik Ole Jensen, Heinz-August Horst, Carlos Fritzsche, Andrea Kühne, Matthias an der Heiden, Osamah Hamouda, Barbara Bartmeyer, ClinSurv Study Group

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

This study aimed to determine the number of people living with HIV receiving antiretroviral therapy (ART) between 2006 and 2013 in Germany by using the available numbers of antiretroviral drug prescriptions and treatment data from the ClinSurv HIV cohort (CSH).

Methods

The CSH is a multi-centre, open, long-term observational cohort study with an average number of 10.400 patients in the study period 2006–2013. ART has been documented on average for 86% of those CSH patients and medication history is well documented in the CSH.
The antiretroviral prescription data (APD) are reported by billing centres for pharmacies covering >99% of nationwide pharmacy sales of all individuals with statutory health insurance (SHI) in Germany (~85%). Exactly one thiacytidine-containing medication (TCM) with either emtricitabine or lamivudine is present in all antiretroviral fixed-dose combinations (FDCs). Thus, each daily dose of TCM documented in the APD is presumed to be representative of one person per day receiving ART. The proportion of non-TCM regimen days in the CSH was used to determine the corresponding number of individuals in the APD.

Results

The proportion of CSH patients receiving TCMs increased continuously over time (from 85% to 93%; 2006–2013). In contrast, treatment interruptions declined remarkably (from 11% to 2%; 2006–2013). The total number of HIV-infected people with ART experience in Germany increased from 31,500 (95% CI 31,000-32,000) individuals to 54,000 (95% CI 53,000-55,500) over the observation period (including 16.3% without SHI and persons who had interrupted ART). An average increase of approximately 2,900 persons receiving ART was observed annually in Germany.

Conclusions

A substantial increase in the number of people receiving ART was observed from 2006 to 2013 in Germany.
Currently, the majority (93%) of antiretroviral regimens in the CSH included TCMs with ongoing use of FDCs. Based on these results, the future number of people receiving ART could be estimated by exclusively using TCM prescriptions, assuming that treatment guidelines will not change with respect to TCM use in ART regimens.
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Metadata
Title
From pills to patients: an evaluation of data sources to determine the number of people living with HIV who are receiving antiretroviral therapy in Germany
Authors
Daniel Schmidt
Christian Kollan
Matthias Stoll
Hans-Jürgen Stellbrink
Andreas Plettenberg
Gerd Fätkenheuer
Frank Bergmann
Johannes R Bogner
Jan van Lunzen
Jürgen Rockstroh
Stefan Esser
Björn-Erik Ole Jensen
Heinz-August Horst
Carlos Fritzsche
Andrea Kühne
Matthias an der Heiden
Osamah Hamouda
Barbara Bartmeyer
ClinSurv Study Group
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-1598-4

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